101
|
Morris JM, Roberts CL, Bowen JR, Patterson JA, Bond DM, Algert CS, Thornton JG, Crowther CA. Immediate delivery compared with expectant management after preterm pre-labour rupture of the membranes close to term (PPROMT trial): a randomised controlled trial. Lancet 2016; 387:444-52. [PMID: 26564381 DOI: 10.1016/s0140-6736(15)00724-2] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Preterm pre-labour ruptured membranes close to term is associated with increased risk of neonatal infection, but immediate delivery is associated with risks of prematurity. The balance of risks is unclear. We aimed to establish whether immediate birth in singleton pregnancies with ruptured membranes close to term reduces neonatal infection without increasing other morbidity. METHODS The PPROMT trial was a multicentre randomised controlled trial done at 65 centres across 11 countries. Women aged over 16 years with singleton pregnancies and ruptured membranes before the onset of labour between 34 weeks and 36 weeks and 6 days weeks who had no signs of infection were included. Women were randomly assigned (1:1) by a computer-generated randomisation schedule with variable block sizes, stratified by centre, to immediate delivery or expectant management. The primary outcome was the incidence of neonatal sepsis. Secondary infant outcomes included a composite neonatal morbidity and mortality indicator (ie, sepsis, mechanical ventilation ≥24 h, stillbirth, or neonatal death); respiratory distress syndrome; any mechanical ventilation; and duration of stay in a neonatal intensive or special care unit. Secondary maternal outcomes included antepartum or intrapartum haemorrhage, intrapartum fever, postpartum treatment with antibiotics, and mode of delivery. Women and caregivers could not be masked, but those adjudicating on the primary outcome were masked to group allocation. Analyses were by intention to treat. This trial is registered with the International Clinical Trials Registry, number ISRCTN44485060. FINDINGS Between May 28, 2004, and June 30, 2013, 1839 women were recruited and randomly assigned: 924 to the immediate birth group and 915 to the expectant management group. One woman in the immediate birth group and three in the expectant group were excluded from the primary analyses. Neonatal sepsis occurred in 23 (2%) of 923 neonates whose mothers were assigned to immediate birth and 29 (3%) of 912 neonates of mothers assigned to expectant management (relative risk [RR] 0·8, 95% CI 0·5-1·3; p=0·37). The composite secondary outcome of neonatal morbidity and mortality occurred in 73 (8%) of 923 neonates of mothers assigned to immediate delivery and 61 (7%) of 911 neonates of mothers assigned to expectant management (RR 1·2, 95% CI 0·9-1·6; p=0·32). However, neonates born to mothers in the immediate delivery group had increased rates of respiratory distress (76 [8%] of 919 vs 47 [5%] of 910, RR 1·6, 95% CI 1·1-2·30; p=0·008) and any mechanical ventilation (114 [12%] of 923 vs 83 [9%] of 912, RR 1·4, 95% CI 1·0-1·8; p=0·02) and spent more time in intensive care (median 4·0 days [IQR 0·0-10·0] vs 2·0 days [0·0-7·0]; p<0·0001) compared with neonates born to mothers in the expectant management group. Compared with women assigned to the immediate delivery group, those assigned to the expectant management group had higher risks of antepartum or intrapartum haemorrhage (RR 0·6, 95% CI 0·4-0·9), intrapartum fever (0·4, 0·2-0·9), and use of postpartum antibiotics (0·8, 0·7-1·0), and longer hospital stay (p<0·0001), but a lower risk of caesarean delivery (RR 1·4, 95% CI 1·2-1·7). INTERPRETATION In the absence of overt signs of infection or fetal compromise, a policy of expectant management with appropriate surveillance of maternal and fetal wellbeing should be followed in pregnant women who present with ruptured membranes close to term. FUNDING Australian National Health and Medical Research Council, the Women's and Children's Hospital Foundation, and The University of Sydney.
Collapse
Affiliation(s)
- Jonathan M Morris
- Perinatal Research, Kolling Institute, Northern Sydney Local Health District, and Sydney Medical School Northern, University of Sydney, St Leonards, NSW, Australia.
| | - Christine L Roberts
- Perinatal Research, Kolling Institute, Northern Sydney Local Health District, and Sydney Medical School Northern, University of Sydney, St Leonards, NSW, Australia
| | - Jennifer R Bowen
- Perinatal Research, Kolling Institute, Northern Sydney Local Health District, and Sydney Medical School Northern, University of Sydney, St Leonards, NSW, Australia; Department of Neonatology, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Jillian A Patterson
- Perinatal Research, Kolling Institute, Northern Sydney Local Health District, and Sydney Medical School Northern, University of Sydney, St Leonards, NSW, Australia
| | - Diana M Bond
- Perinatal Research, Kolling Institute, Northern Sydney Local Health District, and Sydney Medical School Northern, University of Sydney, St Leonards, NSW, Australia
| | - Charles S Algert
- Perinatal Research, Kolling Institute, Northern Sydney Local Health District, and Sydney Medical School Northern, University of Sydney, St Leonards, NSW, Australia
| | - Jim G Thornton
- School of Clinical Sciences, Division of Obstetrics and Gynaecology, City Hospital, University of Nottingham, Nottingham, UK
| | - Caroline A Crowther
- The Robinson Institute, Women's and Children's Hospital, Adelaide, SA, Australia; Liggins Institute, The University of Auckland, Grafton, Auckland, New Zealand
| |
Collapse
|
102
|
Demestre X, Schonhaut L, Morillas J, Martínez-Nadal S, Vila C, Raspall F, Sala P. Development deficit risks in the late premature newborn: Evaluation at 48 months using the Ages & Stages Questionnaires ®. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.anpede.2015.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
103
|
Olivier F, Nadeau S, Caouette G, Piedboeuf B. Association between Apnea of Prematurity and Respiratory Distress Syndrome in Late Preterm Infants: An Observational Study. Front Pediatr 2016; 4:105. [PMID: 27725928 PMCID: PMC5036403 DOI: 10.3389/fped.2016.00105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 09/12/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Late preterm infants (34-36 weeks' gestation) remain a population at risk for apnea of prematurity (AOP). As infants affected by respiratory distress syndrome (RDS) have immature lungs, they might also have immature control of breathing. Our hypothesis is that an association exists between RDS and AOP in late preterm infants. OBJECTIVE The primary objective of this study was to assess the association between RDS and AOP in late preterm infants. The secondary objective was to evaluate if an association exists between apparent RDS severity and AOP. METHODS This retrospective observational study was realized in a tertiary care center between January 2009 and December 2011. Data from late preterm infants who presented an uncomplicated perinatal evolution, excepted for RDS, were reviewed. Information related to AOP and RDS was collected using the medical record. Odds ratios were calculated using a binary logistic regression adjusted for gestational age and sex. RESULTS Among the 982 included infants, 85 (8.7%) had an RDS diagnosis, 281 (28.6%) had AOP diagnosis, and 107 (10.9%) were treated with caffeine for AOP. There was a significant association between AOP treated with caffeine and RDS for all infants (OR = 3.3, 95% CI: 2.0-5.7). There was no association between AOP and RDS in 34 weeks infants [AOR: 1.6 (95% CI: 0.7-3.8)], but an association remains for 35 [AOR: 5.7 (95% CI: 2.5-13.4)] and 36 [OR = 7.8 (95% CI: 3.2-19.4)] weeks infants. No association was found between apparent RDS severity and AOP, regarding mean oxygen administration duration or complications associated with RDS. CONCLUSION The association between RDS and AOP in late preterm infants reflects that patients affected by RDS are not only presenting lung immaturity but also respiratory control immaturity. Special consideration should be given before discontinuing monitoring after RDS resolution in those patients.
Collapse
Affiliation(s)
- François Olivier
- Service of Neonatology, Department of Pediatrics, CHU de Québec-Université Laval , Quebec, QC , Canada
| | - Sophie Nadeau
- Service of Neonatology, Department of Pediatrics, CHU de Québec-Université Laval , Quebec, QC , Canada
| | - Georges Caouette
- Service of Neonatology, Department of Pediatrics, CHU de Québec-Université Laval , Quebec, QC , Canada
| | - Bruno Piedboeuf
- Service of Neonatology, Department of Pediatrics, CHU de Québec-Université Laval , Quebec, QC , Canada
| |
Collapse
|
104
|
Demestre X, Schonhaut L, Morillas J, Martínez-Nadal S, Vila C, Raspall F, Sala P. Riesgo de déficits en el desarrollo en los prematuros tardíos: evaluación a los 48 meses mediante el Ages & Stages Questionnaires®. An Pediatr (Barc) 2016; 84:39-45. [DOI: 10.1016/j.anpedi.2015.02.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 02/17/2015] [Accepted: 02/20/2015] [Indexed: 12/22/2022] Open
|
105
|
Zambrana IM, Vollrath ME, Sengpiel V, Jacobsson B, Ystrom E. Preterm delivery and risk for early language delays: a sibling-control cohort study. Int J Epidemiol 2015; 45:151-9. [PMID: 26686838 DOI: 10.1093/ije/dyv329] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Studies suggest that preterm delivery is a risk factor for early language delays, but knowledge is scarce about the persistence of the delays and whether the association is of a linear kind. To resolve this, effects of confounding risk factors that are both shared within a family and pregnancy specific need to be distinguished from effects of preterm delivery. Our study examines the association between early gestational age and language outcomes, using a sibling-control design. METHODS The sample comprises 22,499 siblings from the Norwegian Mother and Child Birth Cohort Study, recruited between 1999 and 2008. Mothers rated child language comprehension and production at 18 and 36 months. Analyses compared siblings discordant on gestational age group (early preterm, delivery at week 22-33; late preterm, 34-36; early term, 37-38; full term, >38) and type of onset of delivery (spontaneous; provider-initiated), and compared these findings with conventional cohort analyses. RESULTS The findings revealed inverse linear relations between the gestational age groups, and persistent but diminishing language delays. Effects of preterm delivery were substantial on both language production and comprehension at 18 months. By 36 months, the effects of preterm delivery were weaker, but still extensive, in particular for language production in provider-initiated births. When comparing sibling-control with cohort analyses, preterm group was less important among spontaneous births, but remained important in provider-initiated births. Familial and pregnancy risk factors partly explained this. CONCLUSIONS Distinctive factors seem to underlie effects of preterm delivery across spontaneous and provider-initiated births.
Collapse
Affiliation(s)
- Imac M Zambrana
- Norwegian Center for Child Behavioral Development, Oslo, Norway,
| | - Margarete E Vollrath
- Norwegian Institute of Public Health, Division of Mental Health, Oslo, Norway, Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Verena Sengpiel
- Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Bo Jacobsson
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden and Norwegian Institute of Public Health, Division of Epidemiology, Oslo, Norway
| | - Eivind Ystrom
- Norwegian Institute of Public Health, Division of Mental Health, Oslo, Norway, Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| |
Collapse
|
106
|
Validation of the Chilean version of the Ages and Stages Questionnaire (ASQ-CL) in Community Health Settings. Early Hum Dev 2015; 91:671-6. [PMID: 26513627 DOI: 10.1016/j.earlhumdev.2015.10.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 09/25/2015] [Accepted: 10/01/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To validate the translated and cross culturally adapted Chilean version of the 8 and 18month Ages and Stages Questionnaire (ASQ-CL) in a community sample. PARTICIPANTS Parents of 1572 term children (82.9%) and 324 children at risk for developmental delay (17.1%) were included. INSTRUMENT ASQ-3rd edition translated and culturally adapted for Chilean urban population. MAIN MEASURES 8 and 18months ASQ-CL reliability, validity and mean scores. Feasibility was assessed using qualitative methods in healthcare professionals and mothers. RESULTS ASQ-CL mean scores were comparable to U.S. normative data. The overall total score and all domains were reliable (Cronbach alpha 0.66-0.85). Test-retest and inter-rater reliability were high (Pearson's r range 0.73-0.94; intraclass correlation r range 0.68-0.93). Early preterm infants were more likely to fail on several criteria. Qualitative methods confirmed ASQ-CL as a feasible tool in this Chilean urban community. CONCLUSIONS ASQ-CL is a valid, reliable and feasible tool for assessing development in children at 8 and 18months in Chilean urban population.
Collapse
|
107
|
Abstract
OBJECTIVE To assess behavioral outcomes and social competence at 2 years of age in infants born late and moderately preterm (LMPT; 32-36 wk gestation). METHOD One thousand one hundred and thirty LMPT infants and 1255 term-born (≥37 wk) controls were recruited at birth to a prospective geographical population-based study. Parents completed the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 2 years corrected age to assess infants' behavior problems and social competence. Cognitive development was assessed using the Parent Report of Children's Abilities-Revised. Parent questionnaires at 2 years were completed for 638 (57%) LMPT and 765 (62%) term-born infants. Group differences in the prevalence of behavior problems and delayed social competence between LMPT infants and term-born controls were adjusted for age, sex, small-for-gestational-age, socioeconomic status and cognitive impairment. RESULTS Late and moderately preterm infants were at significantly increased risk of delayed social competence compared with term-born controls (26.4% vs. 18.4%; adjusted-relative risk [RR] 1.28; 95% CI, 1.03-1.58), but there was no significant group difference in the prevalence of behavior problems (21.0% vs. 17.6%; adjusted-RR 1.13, 0.89-1.42). Non-white ethnicity (RR 1.68, 1.26-2.24), medium (RR 1.60, 1.14-2.24) and high (RR 1.98, 1.41-2.75) socioeconomic risk and recreational drug use during pregnancy (RR 1.70, 1.03-2.82) were significant independent predictors of delayed social competence in LMPT infants. CONCLUSION Birth at 32 to 36 weeks of gestation confers a specific risk for delayed social competence at 2 years of age. This may be indicative of an increased risk for psychiatric disorders later in childhood.
Collapse
|
108
|
Ichikawa K, Fujiwara T, Nakayama T. Effectiveness of Home Visits in Pregnancy as a Public Health Measure to Improve Birth Outcomes. PLoS One 2015; 10:e0137307. [PMID: 26348847 PMCID: PMC4562632 DOI: 10.1371/journal.pone.0137307] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 08/14/2015] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Birth outcomes, such as preterm birth, low birth weight (LBW), and small for gestational age (SGA), are crucial indicators of child development and health. PURPOSE To evaluate whether home visits from public health nurses for high-risk pregnant women prevent adverse birth outcomes. METHODS In this quasi-experimental cohort study in Kyoto city, Japan, high-risk pregnant women were defined as teenage girls (range 14-19 years old), women with a twin pregnancy, women who registered their pregnancy late, had a physical or mental illness, were of single marital status, non-Japanese women who were not fluent in Japanese, or elderly primiparas. We collected data from all high-risk pregnant women at pregnancy registration interviews held at a public health centers between 1 July 2011 and 30 June 2012, as well as birth outcomes when delivered from the Maternal and Child Health Handbook (N = 964), which is a record of prenatal check-ups, delivery, child development and vaccinations. Of these women, 622 women were selected based on the home-visit program propensity score-matched sample (pair of N = 311) and included in the analysis. Data were analyzed between January and June 2014. RESULTS In the propensity score-matched sample, women who received the home-visit program had lower odds of preterm birth (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.39 to 0.98) and showed a 0.55-week difference in gestational age (95% CI: 0.18 to 0.92) compared to the matched controlled sample. Although the program did not prevent LBW and SGA, children born to mothers who received the program showed an increase in birth weight by 107.8 g (95% CI: 27.0 to 188.5). CONCLUSION Home visits by public health nurses for high-risk pregnant women in Japan might be effective in preventing preterm birth, but not SGA.
Collapse
Affiliation(s)
- Kayoko Ichikawa
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
- Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| |
Collapse
|
109
|
Khan KA, Petrou S, Dritsaki M, Johnson SJ, Manktelow B, Draper ES, Smith LK, Seaton SE, Marlow N, Dorling J, Field DJ, Boyle EM. Economic costs associated with moderate and late preterm birth: a prospective population-based study. BJOG 2015. [PMID: 26219352 DOI: 10.1111/1471-0528.13515] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We sought to determine the economic costs associated with moderate and late preterm birth. DESIGN An economic study was nested within a prospective cohort study. SAMPLE Infants born between 32(+0) and 36(+6) weeks of gestation in the East Midlands of England. A sample of infants born at ≥37 weeks of gestation acted as controls. METHODS Data on resource use, estimated from a National Health Service (NHS) and personal social services perspective, and separately from a societal perspective, were collected between birth and 24 months corrected age (or death), and valued in pounds sterling, at 2010-11 prices. Descriptive statistics and multivariable analyses were used to estimate the relationship between gestational age at birth and economic costs. MAIN OUTCOME MEASURES Cumulative resource use and economic costs over the first two years of life. RESULTS Of all eligible births, 1146 (83%) preterm and 1258 (79%) term infants were recruited. Mean (standard error) total societal costs from birth to 24 months were £12 037 (£1114) and £5823 (£1232) for children born moderately preterm (32(+0) -33(+6) weeks of gestation) and late preterm (34(+0) -36(+6) weeks of gestation), respectively, compared with £2056 (£132) for children born at term. The mean societal cost difference between moderate and late preterm and term infants was £4657 (bootstrap 95% confidence interval, 95% CI £2513-6803; P < 0.001). Multivariable regressions revealed that, after controlling for clinical and sociodemographic characteristics, moderate and late preterm birth increased societal costs by £7583 (£874) and £1963 (£337), respectively, compared with birth at full term. CONCLUSIONS Moderate and late preterm birth is associated with significantly increased economic costs over the first 2 years of life. Our economic estimates can be used to inform budgetary and service planning by clinical decision-makers, and economic evaluations of interventions aimed at preventing moderate and late preterm birth or alleviating its adverse consequences. TWEETABLE ABSTRACT Moderate and late preterm birth is associated with increased economic costs over the first 2 years of life.
Collapse
Affiliation(s)
- K A Khan
- University of Warwick, Coventry, UK
| | - S Petrou
- University of Warwick, Coventry, UK
| | | | | | | | | | - L K Smith
- University of Leicester, Leicester, UK
| | | | - N Marlow
- University College London, London, UK
| | - J Dorling
- University of Nottingham, Nottingham, UK
| | - D J Field
- University of Leicester, Leicester, UK
| | - E M Boyle
- University of Leicester, Leicester, UK
| |
Collapse
|
110
|
Johnson S, Evans TA, Draper ES, Field DJ, Manktelow BN, Marlow N, Matthews R, Petrou S, Seaton SE, Smith LK, Boyle EM. Neurodevelopmental outcomes following late and moderate prematurity: a population-based cohort study. Arch Dis Child Fetal Neonatal Ed 2015; 100:F301-8. [PMID: 25834170 PMCID: PMC4484499 DOI: 10.1136/archdischild-2014-307684] [Citation(s) in RCA: 183] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 01/01/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE There is a paucity of data relating to neurodevelopmental outcomes in infants born late and moderately preterm (LMPT; 32(+0)-36(+6) weeks). This paper present the results of a prospective, population-based study of 2-year outcomes following LMPT birth. DESIGN 1130 LMPT and 1255 term-born children were recruited at birth. At 2 years corrected age, parents completed a questionnaire to assess neurosensory (vision, hearing, motor) impairments and the Parent Report of Children's Abilities-Revised to identify cognitive impairment. Relative risks for adverse outcomes were adjusted for sex, socio-economic status and small for gestational age, and weighted to account for over-sampling of term-born multiples. Risk factors for cognitive impairment were explored using multivariable analyses. RESULTS Parents of 638 (57%) LMPT infants and 765 (62%) controls completed questionnaires. Among LMPT infants, 1.6% had neurosensory impairment compared with 0.3% of controls (RR 4.89, 95% CI 1.07 to 22.25). Cognitive impairments were the most common adverse outcome: LMPT 6.3%; controls 2.4% (RR 2.09, 95% CI 1.19 to 3.64). LMPT infants were at twice the risk for neurodevelopmental disability (RR 2.19, 95% CI 1.27 to 3.75). Independent risk factors for cognitive impairment in LMPT infants were male sex, socio-economic disadvantage, non-white ethnicity, preeclampsia and not receiving breast milk at discharge. CONCLUSIONS Compared with term-born peers, LMPT infants are at double the risk for neurodevelopmental disability at 2 years of age, with the majority of impairments observed in the cognitive domain. Male sex, socio-economic disadvantage and preeclampsia are independent predictors of low cognitive scores following LMPT birth.
Collapse
Affiliation(s)
- Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - T Alun Evans
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - David J Field
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Neil Marlow
- Department of Academic Neonatology, Institute for Women's Health, University College London, London, UK
| | - Ruth Matthews
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Stavros Petrou
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Sarah E Seaton
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Lucy K Smith
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Elaine M Boyle
- Department of Health Sciences, University of Leicester, Leicester, UK
| |
Collapse
|
111
|
Ribicic R, Kranjcec I, Borosak J, Tumbri J, Mihovilovic Prajz L, Ribicic T. Perinatal outcome of singleton versus twin late preterm infants: do twins mature faster than singletons? J Matern Fetal Neonatal Med 2015; 29:1520-4. [DOI: 10.3109/14767058.2015.1053449] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
112
|
Degnan AJ, Wisnowski JL, Choi S, Ceschin R, Bhushan C, Leahy RM, Corby P, Schmithorst VJ, Panigrahy A. 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. PLoS One 2015; 10:e0130686. [PMID: 26098888 PMCID: PMC4476681 DOI: 10.1371/journal.pone.0130686] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 05/22/2015] [Indexed: 11/19/2022] Open
Abstract
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 despite no significant executive neurocognitive differences. Selective increased structural connectivity was observed in the setting of decreased posterior interhemispheric connections. Future work is needed to determine if these findings represent a compensatory adaptation employing alternate neural circuitry or could reflect subtle pathology resulting in emotional processing deficits not seen with neurocognitive testing.
Collapse
Affiliation(s)
- Andrew J. Degnan
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Department of Radiology, University of Pittsburgh Medical Center (UPMC), 3950 Presby South Tower, 200 Lothrop Street, Pittsburgh, PA 15213, United States of America
| | - Jessica L. Wisnowski
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
- Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, CA 90027, United States of America
| | - SoYoung Choi
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
| | - Rafael Ceschin
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Chitresh Bhushan
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA 90089, United States of America
| | - Richard M. Leahy
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA 90089, United States of America
| | - Patricia Corby
- Twins Institute for Genetics Research, Montes Claros, Minas Gerais 39400–115, Brazil
- New York University Bluestone Center for Clinical Research, 421 1st Ave, New York, NY 10010, United States of America
| | - Vincent J. Schmithorst
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
| | - Ashok Panigrahy
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
- Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, CA 90027, United States of America
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States of America
| |
Collapse
|
113
|
Schonhaut L, Armijo I, Pérez M. Gestational age and developmental risk in moderately and late preterm and early term infants. Pediatrics 2015; 135:e835-41. [PMID: 25733752 DOI: 10.1542/peds.2014-1957] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The objective of this study was to evaluate the association between gestational age (GA) at birth and risk of developmental delay at 8 and 18 months of corrected postnatal age. METHODS During 2008 to 2011, infants at a corrected postnatal age of 8 or 18 months attending health centers in Santiago, Chile, were recruited. Participants completed a form on biographical and demographic characteristics and the Chilean validated version of the Ages and Stages Questionnaires, Third Edition (ASQ). Logistic regression was used to detect the capacity of GA to predict scores < -2 SDs on the basis of the Chilean ASQ reference group, in at least 1 ASQ domain, adjusted by different control variables. RESULTS A total of 1667 infants were included in the analysis. An inverse "dose response" relationship between developmental delay risk and GA at birth was found, both in the crude and adjusted models. Compared with those born full term, the odds ratio for developmental delay risk was 1.56 for those born early term (95% confidence interval [CI]: 1.19-2.06), 2.58 for infants born late preterm (95%CI: 1.66-4.01), and 3.01 for those born moderately preterm (95%CI: 1.59-5.71). CONCLUSIONS An inverse dose-response relationship between GA and risk of developmental delay was found in the tested population. Future prospective studies and predictive models are needed to understand whether this higher developmental risk in moderately and late preterm infants is transient and modifiable or persists throughout life, allowing for better targeting of early-intervention strategies.
Collapse
Affiliation(s)
- Luisa Schonhaut
- Departmento de Pediatria, Clínica Alemana, Santiago, Chile; Facultad de Medicina, Clinica Alemana-Universidad del Desarrollo, Santiago, Chile; and
| | - Iván Armijo
- Facultad de Psicología, Universidad Gabriela Mistral, Santiago, Chile
| | - Marcela Pérez
- Departmento de Pediatria, Clínica Alemana, Santiago, Chile; Facultad de Medicina, Clinica Alemana-Universidad del Desarrollo, Santiago, Chile; and
| |
Collapse
|
114
|
Richards JL, Chapple-McGruder T, Williams BL, Kramer MR. Does neighborhood deprivation modify the effect of preterm birth on children's first grade academic performance? Soc Sci Med 2015; 132:122-31. [PMID: 25797101 DOI: 10.1016/j.socscimed.2015.03.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Children's cognitive development and academic performance are linked to both fetal and early childhood factors, including preterm birth and family socioeconomic status. We evaluated whether the relationship between preterm birth (PTB) and first grade standardized test performance among Georgia public school students was modified by neighborhood deprivation in early childhood. The Georgia Birth to School cohort followed 327,698 children born in Georgia from 1998 to 2002 through to end-of-year first grade standardized tests. Binomial and log-binomial generalized estimating equations were used to estimate risk differences and risk ratios for the associations of both PTB and the Neighborhood Deprivation Index for the census tract in which each child's mother resided at the time of birth with test failure (versus passing). The presence of additive and multiplicative interaction was assessed. PTB was strongly associated with test failure, with increasing risk for earlier gestational ages. There was positive additive interaction between PTB and neighborhood deprivation. The main effect of PTB versus term birth increased risk of mathematics failure: 15.9% (95%CI: 13.3-18.5%) for early, 5.0% (95% CI: 4.1-5.9%) for moderate, and 1.3% (95%CI: 0.9-1.7%) for late preterm. Each 1 standard deviation increase in neighborhood deprivation was associated with 0.6% increased risk of mathematics failure. For children exposed to both PTB and higher neighborhood deprivation, test failure was 4.8%, 1.5%, and 0.8% greater than the sum of two main effects for early, moderate, and late PTB, respectively. Results were similar, but slightly attenuated, for reading and English/language arts. Our results suggest that PTB and neighborhood deprivation additively interact to produce greater risk among doubly exposed children than would be predicted from the sum of the effects of the two exposures. Understanding socioeconomic disparities in the effect of PTB on academic outcomes at school entry is important for targeting of early childhood interventions.
Collapse
Affiliation(s)
- Jennifer L Richards
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Theresa Chapple-McGruder
- Office of Epidemiology, Maternal and Child Health Program, Georgia State Department of Health, 2 Peachtree Street NW, Atlanta, GA 30303, USA.
| | - Bryan L Williams
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA; Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA 30322-4027, USA.
| | - Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| |
Collapse
|
115
|
Gerry Taylor H. Multiple risks for long-term cognitive impairments following preterm birth. Acta Paediatr 2015; 104:218-20. [PMID: 25689325 DOI: 10.1111/apa.12900] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- H. Gerry Taylor
- Pediatrics; Case Western Reserve University and Rainbow Babies & Children's Hospital; University Hospitals Case Medical Center; Cleveland OH USA
| |
Collapse
|
116
|
Tanis JC, Van Braeckel KNJA, Kerstjens JM, Bocca-Tjeertes IFA, Reijneveld SA, Bos AF. Functional outcomes at age 7 years of moderate preterm and full term children born small for gestational age. J Pediatr 2015; 166:552-8.e1. [PMID: 25575420 DOI: 10.1016/j.jpeds.2014.11.043] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 10/14/2014] [Accepted: 11/19/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To compare functional outcomes of 7-year-old (school-age) children born small for gestational age (SGA; ie, a birth weight z score ≤ -1 SD), with appropriate for gestational age (AGA) peers, born moderately preterm or full term. STUDY DESIGN Data were collected as part of the Longitudinal Preterm Outcome Project study, a community-based, prospective cohort study of 336 AGA and 42 SGA born children (median gestational age 35 weeks, range 31-41). Of the SGA children, 32 were moderately preterm, 10 were full term; of the AGA, these numbers were 216 and 120, respectively. At 6.9 years, we assessed intelligence, verbal memory, attention, visuomotor integration, and motor skills and we collected the parent-reported executive functioning. We compared the outcomes of the SGA children with those of their AGA peers. RESULTS The performance of SGA children was similar to that of their AGA peers, except for attention control which was abnormal more often in SGA children (OR 3.99, 95% CI 1.32-12.12). The IQ of SGA children was 3 points lower, but this difference failed to reach significance. CONCLUSIONS At school age, children born SGA have a greater risk of abnormal test scores on attention control than children born AGA, independent of gestational age. Their motor and many other cognitive functions are similar. The impact of these outcomes seems limited. Nevertheless, the consequences for school performance deserve attention.
Collapse
Affiliation(s)
- Jozien C Tanis
- Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Koenraad N J A Van Braeckel
- Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jorien M Kerstjens
- Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Inger F A Bocca-Tjeertes
- Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arend F Bos
- Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
117
|
Bilingualism as a potential strategy to improve executive function in preterm infants: a review. J Pediatr Health Care 2015; 29:126-36. [PMID: 25280949 DOI: 10.1016/j.pedhc.2014.08.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 07/30/2014] [Accepted: 08/08/2014] [Indexed: 11/21/2022]
Abstract
Preterm birth is associated with long-term deficits in executive functioning and cognitive performance. Using the model of brain plasticity as a theoretical framework, it is possible that preterm infants' neurodevelopmental sequelae can be altered. Evidence suggests that bilingualism confers cognitive advantages on executive functioning, so it is possible that bilingualism may improve preterm infants' neurodevelopment. However, bilingualism has only been studied in term children. This review examined literature that compared the performance of preterm-born children to term children and bilingual children to monolingual children on executive function tasks. To address cognitive disparities in preterm-born children, studies investigating the effect of bilingualism on preterm infants' executive functioning is warranted.
Collapse
|
118
|
de Albuquerque PL, Lemos A, Guerra MQDF, Eickmann SH. Accuracy of the Alberta Infant Motor Scale (AIMS) to detect developmental delay of gross motor skills in preterm infants: a systematic review. Dev Neurorehabil 2015; 18:15-21. [PMID: 25279804 DOI: 10.3109/17518423.2014.955213] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess, through a systematic review, the ability of Alberta Infant Motor Scale (AIMS) to diagnose delayed motor development in preterm infants. METHODS Systematic searches identified five studies meeting inclusion criteria. These studies were evaluated in terms of: participants' characteristics, main results and risk of bias. The risk of bias was assessed with the Quality Assessment of Diagnostic Accuracy Studies--second edition (QUADAS-2). RESULTS All five studies included a high risk of bias in at least one of the assessed fields. The most frequent biases included were presented in patient selection and lost follow up. All studies used the Pearson correlation coefficient to assess the diagnostic capability of the Alberta Infant Motor Scale. None of the assessed studies used psychometric measures to analyze the data. CONCLUSION Given the evidence, the research supporting the ability of Alberta Infant Motor Scale to diagnose delayed motor development in preterm infants presents limitations. Further studies are suggested in order to avoid the above-mentioned biases to assess the Alberta Infant Motor Scale accuracy in preterm babies.
Collapse
|
119
|
Kitsommart R, Phatihattakorn C, Pornladnun P, Paes B. A prospective study of the severity of early respiratory distress in late preterms compared to term infants. J Matern Fetal Neonatal Med 2014; 29:207-12. [DOI: 10.3109/14767058.2014.992335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ratchada Kitsommart
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,
| | - Chayawat Phatihattakorn
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, and
| | - Pornpat Pornladnun
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,
| | - Bosco Paes
- Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
120
|
Benzies KM, Magill-Evans J. THROUGH THE EYES OF A NEW DAD: EXPERIENCES OF FIRST-TIME FATHERS OF LATE-PRETERM INFANTS. Infant Ment Health J 2014; 36:78-87. [DOI: 10.1002/imhj.21489] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
121
|
Stene-Larsen K, Brandlistuen RE, Lang AM, Landolt MA, Latal B, Vollrath ME. Communication impairments in early term and late preterm children: a prospective cohort study following children to age 36 months. J Pediatr 2014; 165:1123-8. [PMID: 25258153 DOI: 10.1016/j.jpeds.2014.08.027] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 06/20/2014] [Accepted: 08/13/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate the risk of communication impairments at age 18 and 36 months in children born early term (gestational weeks 37-38) and late preterm (gestational weeks 34-36). STUDY DESIGN A total of 39 423 children and their mothers participated in the Norwegian Mother and Child Cohort Study. The sample included 7109 children (18%) born early term and 1673 (4.2%) born late preterm. Information on gestational age and prenatal and postnatal risk factors was obtained from the Medical Birth Registry of Norway. Information on communication impairments was assessed using standardized questionnaires filled out by the mothers. Stepwise logistic regression analysis was applied to explore the associations between early term/late preterm birth and communication impairments at age 18 and 36 months. RESULTS Compared with children born at term, children born early term and late preterm had an increased risk of communication impairments at age 18 and 36 months. In early term, the aOR was 1.27 (95% CI, 1.12-1.44) at 18 months for communication impairments and 1.22 (95% CI, 1.07-1.39) at 36 months for expressive language impairments. In late preterm, the aOR was 1.74 (95% CI, 1.41-2.14) at 18 months and 1.37 (95% CI, 1.09-1.73) at 36 months. CONCLUSION Not only children born late preterm, but also those born early term, are at increased risk for communication impairments. Given the large number of children potentially affected, this may result in significant health care costs.
Collapse
Affiliation(s)
- Kim Stene-Larsen
- Department of Psychosomatics and Health Behaviors, Norwegian Institute of Public Health, Oslo, Norway.
| | - Ragnhild Eek Brandlistuen
- Department of Psychosomatics and Health Behaviors, Norwegian Institute of Public Health, Oslo, Norway; School of Pharmacy, University of Oslo, Oslo, Norway
| | - Astri M Lang
- Department of Neonatal Intensive Care, Women and Children's Division, Oslo University Hospital, Oslo, Norway
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland; Department of Child and Adolescent Health Psychology, Psychological Institute, University of Zurich, Zurich, Switzerland
| | - Beatrice Latal
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Margarete E Vollrath
- Department of Psychosomatics and Health Behaviors, Norwegian Institute of Public Health, Oslo, Norway; Psychological Institute, University of Oslo, Oslo, Norway
| |
Collapse
|
122
|
Espel EV, Glynn LM, Sandman CA, Davis EP. Longer gestation among children born full term influences cognitive and motor development. PLoS One 2014; 9:e113758. [PMID: 25423150 PMCID: PMC4244187 DOI: 10.1371/journal.pone.0113758] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/29/2014] [Indexed: 11/18/2022] Open
Abstract
Children born preterm show persisting impairments in cognitive functioning, school achievement, and brain development. Most research has focused on implications of birth prior to 37 gestational weeks; however, the fetal central nervous system continues to make fundamental changes throughout gestation. Longer gestation is associated with reduced morbidity and mortality even among infants born during the period clinically defined as full term (37-41 gestational weeks). The implications of shortened gestation among term infants for neurodevelopment are poorly understood. The present study prospectively evaluates 232 mothers and their full term infants (50.4% male infants) at three time points across the first postnatal year. We evaluate the association between gestational length and cognitive and motor development. Infants included in the study were full term (born between 37 and 41 weeks gestation). The present study uses the combination of Last Menstrual Period (LMP) and early ultrasound for accurate gestational dating. Hierarchical Linear Regression analyses revealed that longer gestational length is associated with higher scores on the Bayley scales of mental and motor development at 3, 6 and 12 months of age after considering socio-demographic, pregnancy, and infant-level covariates. Findings were identical using revised categories of early, term, and late term proposed by the Working Group for Defining Term Pregnancy. Our findings indicate that longer gestation, even among term infants, benefits both cognitive and motor development.
Collapse
Affiliation(s)
- Emma V. Espel
- Department of Psychology, University of Denver, Denver, Colorado, United States of America
| | - Laura M. Glynn
- Department of Psychology, Crean College of Health and Behavioral Sciences, Chapman University, Orange, California, United States of America
| | - Curt A. Sandman
- Department of Psychiatry and Human Behavior, College of Medicine, University of California Irvine, Irvine, California, United States of America
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, Colorado, United States of America
- Department of Psychiatry and Human Behavior, College of Medicine, University of California Irvine, Irvine, California, United States of America
- * E-mail:
| |
Collapse
|
123
|
Boylan J, Alderdice FA, McGowan JE, Craig S, Perra O, Jenkins J. Behavioural outcomes at 3 years of age among late preterm infants admitted to neonatal intensive care: a cohort study. Arch Dis Child Fetal Neonatal Ed 2014; 99:F359-65. [PMID: 24812103 DOI: 10.1136/archdischild-2013-304785] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Examine the behavioural outcomes at age 3 years of late preterm infants (LPIs) who were admitted to neonatal intensive care (NIC) in comparison with LPIs who were not admitted. METHOD This cohort study prospectively recruited 225 children born late preterm (34-36(+6) weeks gestation) in 2006 in Northern Ireland, now aged 3 years. Two groups were compared: LPIs who received NIC (study; n=103) and LPIs who did not receive NIC (control; n=122). Parents/guardians completed the Child Behaviour Checklist/1½-5. Descriptive maternal and infant data were also collected. RESULTS As expected LPI children admitted to NIC had higher medical risk than the non-admitted comparison group (increased caesarean section, born at earlier gestation, lower birth weight and an episode of resuscitation at birth). LPIs admitted to NIC scored higher on the Child Behaviour Checklist/1½-5 compared with those who were not admitted indicating more behavioural problems; this was statistically significant for the Aggressive Behaviour Subscale (z=-2.36) and the Externalising Problems Scale (z=-2.42). The group difference on the Externalising Problems Scale was no longer significant after controlling for gender, gestational age and deprivation score. CONCLUSIONS This study provides valuable data on the behaviour at age 3 years of LPIs admitted to NIC compared with LPIs not admitted to NIC. Further research would be beneficial to explore medical and psychosocial explanations for observed differences between groups using large prospective cohort studies.
Collapse
Affiliation(s)
- Jackie Boylan
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Fiona A Alderdice
- School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, Belfast, UK
| | - Jennifer E McGowan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Stanley Craig
- Royal Jubilee Maternity Hospital, Neonatal Intensive Care, Belfast, Northern Ireland
| | - Oliver Perra
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - John Jenkins
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| |
Collapse
|
124
|
Parets SE, Bedient CE, Menon R, Smith AK. Preterm birth and its long-term effects: methylation to mechanisms. BIOLOGY 2014; 3:498-513. [PMID: 25256426 PMCID: PMC4192624 DOI: 10.3390/biology3030498] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 08/08/2014] [Accepted: 08/12/2014] [Indexed: 01/06/2023]
Abstract
The epigenetic patterns established during development may influence gene expression over a lifetime and increase susceptibility to chronic disease. Being born preterm (<37 weeks of gestation) is associated with increased risk mortality and morbidity from birth until adulthood. This brief review explores the potential role of DNA methylation in preterm birth (PTB) and its possible long-term consequences and provides an overview of the physiological processes central to PTB and recent DNA methylation studies of PTB.
Collapse
Affiliation(s)
- Sasha E Parets
- Genetics and Molecular Biology Program, Emory University, Atlanta, GA 30322, USA.
| | - Carrie E Bedient
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA 30322, USA.
| | - Ramkumar Menon
- Division of Maternal-Fetal Medicine Perinatal Research, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA.
| | - Alicia K Smith
- Genetics and Molecular Biology Program, Emory University, Atlanta, GA 30322, USA.
| |
Collapse
|
125
|
Ristovska G, Laszlo HE, Hansell AL. Reproductive outcomes associated with noise exposure - a systematic review of the literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:7931-52. [PMID: 25101773 PMCID: PMC4143841 DOI: 10.3390/ijerph110807931] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 07/08/2014] [Accepted: 07/16/2014] [Indexed: 01/30/2023]
Abstract
Introduction: High noise exposure during critical periods in gestation is a potential stressor that may result in increased risk of implantation failure, dysregulation of placentation or decrease of uterine blood flow. This paper systematically reviews published evidence on associations between reproductive outcomes and occupational and environmental noise exposure. Methods: The Web of Science, PubMed and Embase electronic databases were searched for papers published between 1970 to June 2014 and via colleagues. We included 14 epidemiological studies related to occupational noise exposure and nine epidemiological studies related to environmental noise exposure. There was some evidence for associations between occupational noise exposure and low birthweight, preterm birth and small for gestational age, either independently or together with other occupational risk factors. Five of six epidemiologic studies, including the two largest studies, found significant associations between lower birthweight and higher noise exposure. There were few studies on other outcomes and study design issues may have led to bias in assessments in some studies. Conclusions: There is evidence for associations between noise exposure and adverse reproductive outcomes from animal studies. Few studies in have been conducted in humans but there is some suggestive evidence of adverse associations with environmental noise from both occupational and epidemiological studies, especially for low birthweight.
Collapse
Affiliation(s)
- Gordana Ristovska
- Department for Environmental Health, Institute of Public Health of Republic of Macedonia, 50 Divizija No. 6, Skopje 1000, Republic of Macedonia.
| | - Helga Elvira Laszlo
- MRC-PHE Centre for Environment and Health, Imperial College London, London W2 1PG, UK.
| | - Anna L Hansell
- MRC-PHE Centre for Environment and Health, Imperial College London, London W2 1PG, UK.
| |
Collapse
|
126
|
Nunes CR, Abdala LG, Beghetto MG. [Clinical outcomes in the first year of life of premature infants]. Rev Gaucha Enferm 2014; 34:21-7. [PMID: 25080696 DOI: 10.1590/s1983-14472013000400003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this retrospective cohort study was to investigate clinical outcomes of the first year of life of premature infants discharged from the Neonatal Intensive Care Unit (NICU) based on mortality and readmission data, and the motor development of the children. The sample consisted of 170 children with gestational age under 37 weeks and who survived hospitalization in neonatal intensive care unit (NICU). Data were collected from medical records, the hospital IT system and telephone interview with the caregiver. The authors found 100% survival during the study period and that 39.4% of the infants were often readmitted (26.5%) due to respiratory conditions. Their development was considered as expected, when using the corrected age. In conclusion, the premature infants from this study showed good clinical evolution of the proposed observation.
Collapse
|
127
|
Apkon SD, Grady R, Hart S, Lee A, McNalley T, Niswander L, Petersen J, Remley S, Rotenstein D, Shurtleff H, Warner M, Walker WO. Advances in the care of children with spina bifida. Adv Pediatr 2014; 61:33-74. [PMID: 25037124 DOI: 10.1016/j.yapd.2014.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Susan D Apkon
- Rehabilitation Medicine, University of Washington, Seattle, WA, USA; Rehabilitation Medicine, Seattle Children's Hospital, 4800 Sand Point Way Northeast, M/S OB-8414, Seattle, WA 98105, USA.
| | - Richard Grady
- Section of Pediatric Urology, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA
| | - Solveig Hart
- Rehabilitation Services, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA
| | - Amy Lee
- Pediatric Neurosurgery, Seattle Children's Hospital, University of Washington, 4800 Sand Point Way Northeast, M/S W7729, PO Box 5371, Seattle, WA 98105, USA
| | - Thomas McNalley
- Rehabilitation Medicine, Seattle Children's Hospital, University of Washington, 4800 Sand Point Way Northeast, M/S OB-8404, Seattle, WA 98105, USA
| | - Lee Niswander
- Department of Pediatrics, Children's Hospital Colorado, Howard Hughes Medical Institute, University of Colorado School of Medicine, Mail Stop 8133, Building RC1 South, Room L18-12106, 12801 East 17th Avenue, Aurora, CO 80045, USA
| | - Juliette Petersen
- Molecular Biology Program, University of Colorado Denver Anschutz Medical Campus, Mail Stop 8133, Building RC1 South, L18-12400D, 12801 East 17th Avenue, Aurora, CO 80045, USA
| | - Sheridan Remley
- Rehabilitation Services, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA
| | - Deborah Rotenstein
- Pediatric Endocrinology, Endocrine Division, Pediatric Alliance, 1789 South Braddock Avenue, Suite 294, Pittsburgh, PA 15218, USA
| | - Hillary Shurtleff
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA; Department of Child Psychiatry, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA
| | - Molly Warner
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA; Neuropsychology Consult Service, Department of Psychiatry, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA
| | - William O Walker
- Division of Developmental Medicine, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way Northeast, M/S OC.9.940, Seattle, WA 98105, USA
| |
Collapse
|
128
|
Blaggan S, Guy A, Boyle EM, Spata E, Manktelow BN, Wolke D, Johnson S. A parent questionnaire for developmental screening in infants born late and moderately preterm. Pediatrics 2014; 134:e55-62. [PMID: 24982100 DOI: 10.1542/peds.2014-0266] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The Parent Report of Children's Abilities-Revised (PARCA-R) is a questionnaire for assessing cognitive and language development in very preterm infants. Given the increased risk of developmental delay in infants born late and moderately preterm (LMPT; 32-36 weeks), this study aimed to validate this questionnaire as a screening tool in this population. METHODS Parents of 219 children born LMPT completed the PARCA-R questionnaire and the Brief Infant Toddler Social and Emotional Assessment when children were 24 months corrected age (range, 24 months-27 months). The children were subsequently assessed by using the cognitive and language scales of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). RESULTS An average Bayley-III, cognitive and language (CB-III) score and a total PARCA-R Parent Report Composite (PRC) score were computed. There was a large association between PRC and CB-III scores (r = 0.66, P < .001) indicating good concurrent validity. Using Youden index, the optimum PARCA-R cutoff for identifying children with moderate/severe developmental delay (CB-III scores < 80) was PRC scores < 73. This gave sensitivity 0.90 (95% confidence interval: 0.75-1.00) and specificity 0.76 (95% confidence interval: 0.70-0.82), indicating good diagnostic utility. Approximately two-thirds of the children who had a PRC score < 73 had false-positive screens. However, these children had significantly poorer cognitive and behavioral outcomes than children with true negative screens. CONCLUSIONS The PARCA-R has good concurrent validity with a gold standard developmental test and can be used to identify LMPT infants who may benefit from a clinical assessment. The PARCA-R has potential for clinical use as a first-line cognitive screening tool for this sizeable population of infants in whom follow-up may be beneficial.
Collapse
Affiliation(s)
- Samarita Blaggan
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and
| | - Alexa Guy
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and
| | - Elaine M Boyle
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and
| | - Enti Spata
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and
| | - Bradley N Manktelow
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and
| | - Dieter Wolke
- Department of Psychology and Health Sciences Research Institute and Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and
| |
Collapse
|
129
|
Abstract
Preterm birth is defined as birth before 37 completed weeks gestation, and it is estimated that each day, across the world over 41,000 infants are born before this gestational age. The risk of adverse consequences declines with increasing gestational age. While this paper focuses on the consequences of preterm birth, the adverse consequences for infants born at 38 and 39 weeks gestation are also of a higher risk than those for infants born at 40 weeks gestation, with the neonatal mortality risk increasing again in infants born beyond the 42nd week of gestation.
Collapse
Affiliation(s)
- M J Platt
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK.
| |
Collapse
|
130
|
Reuner G, Weinschenk A, Pauen S, Pietz J. 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. Child Neuropsychol 2014; 21:314-30. [PMID: 24697340 DOI: 10.1080/09297049.2014.899571] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
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.
Collapse
Affiliation(s)
- Gitta Reuner
- a Section Neuropediatrics , Children's University Hospital , Heidelberg , Baden-Wuerttemberg , Germany
| | | | | | | |
Collapse
|
131
|
McGowan JE, Alderdice FA, Boylan J, Holmes VA, Jenkins J, Craig S, Perra O, Johnston L. Neonatal intensive care and late preterm infants: health and family functioning at three years. Early Hum Dev 2014; 90:201-5. [PMID: 24485967 DOI: 10.1016/j.earlhumdev.2014.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 12/30/2013] [Accepted: 01/03/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Late preterm infants (LPIs), born at 34+0 to 36+6 weeks of gestation contribute a significant proportion of all neonatal intensive care (NIC) admissions and are regarded as being at risk of adverse outcomes compared to term-born infants. AIM To explore the health outcomes and family functioning of LPIs who required neonatal intensive care, at three years of age. STUDY DESIGN AND SUBJECTS This cohort study included 225 children born late preterm, between 1 January and 31 December 2006 in Northern Ireland. Children admitted for NIC (study group, n=103) were compared with children who did not require NIC or who required special care only for up to three days (comparison group, n=122). OUTCOME MEASURES Health outcomes were measured using the Health Status Questionnaire, health service usage by parent report and family functioning using the PedsQL™ Family Impact Module. RESULTS LPIs who required NIC revealed similar health outcomes at three years in comparison to those who did not. Despite this, more parents of LPIs who required NIC reported visiting their GP and medical specialists during their child's third year of life. Differences in family functioning were also observed with mothers of LPIs who required NIC reporting, significantly lower levels of social and physical functioning, increased difficulties with communication and increased levels of worry. CONCLUSIONS LPIs were observed to have similar health outcomes at three years of age regardless of NIC requirement. The increase in GP and medical specialist visits and family functioning difficulties observed among those infants who required NIC merits further investigation.
Collapse
Affiliation(s)
- Jennifer E McGowan
- School of Nursing and Midwifery, Queen's University Belfast, United Kingdom
| | - Fiona A Alderdice
- School of Nursing and Midwifery, Queen's University Belfast, United Kingdom.
| | - Jackie Boylan
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, United Kingdom
| | - Valerie A Holmes
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, United Kingdom
| | - John Jenkins
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, United Kingdom
| | - Stanley Craig
- NICORE Project, Royal Jubilee Maternity Service, Belfast, United Kingdom
| | - Oliver Perra
- School of Nursing and Midwifery, Queen's University Belfast, United Kingdom
| | - Linda Johnston
- School of Nursing and Midwifery, Queen's University Belfast, United Kingdom
| |
Collapse
|
132
|
Hyder A, Lee HJ, Ebisu K, Koutrakis P, Belanger K, Bell ML. PM2.5 exposure and birth outcomes: use of satellite- and monitor-based data. Epidemiology 2014; 25:58-67. [PMID: 24240652 PMCID: PMC4009503 DOI: 10.1097/ede.0000000000000027] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Air pollution may be related to adverse birth outcomes. Exposure information from land-based monitoring stations often suffers from limited spatial coverage. Satellite data offer an alternative data source for exposure assessment. METHODS We used birth certificate data for births in Connecticut and Massachusetts, United States (2000-2006). Gestational exposure to PM2.5 was estimated from US Environmental Protection Agency monitoring data and from satellite data. Satellite data were processed and modeled by using two methods-denoted satellite (1) and satellite (2)-before exposure assessment. Regression models related PM2.5 exposure to birth outcomes while controlling for several confounders. Birth outcomes were mean birth weight at term birth, low birth weight at term (<2500 g), small for gestational age (SGA, <10th percentile for gestational age and sex), and preterm birth (<37 weeks). RESULTS Overall, the exposure assessment method modified the magnitude of the effect estimates of PM2.5 on birth outcomes. Change in birth weight per interquartile range (2.41 μg/m) increase in PM2.5 was -6 g (95% confidence interval = -8 to -5), -16 g (-21 to -11), and -19 g (-23 to -15), using the monitor, satellite (1), and satellite (2) methods, respectively. Adjusted odds ratios, based on the same three exposure methods, for term low birth weight were 1.01 (0.98-1.04), 1.06 (0.97-1.16), and 1.08 (1.01-1.16); for SGA, 1.03 (1.01-1.04), 1.06 (1.03-1.10), and 1.08 (1.04-1.11); and for preterm birth, 1.00 (0.99-1.02), 0.98 (0.94-1.03), and 0.99 (0.95-1.03). CONCLUSIONS Under exposure assessment methods, we found associations between PM2.5 exposure and adverse birth outcomes particularly for birth weight among term births and for SGA. These results add to the growing concerns that air pollution adversely affects infant health and suggest that analysis of health consequences based on satellite-based exposure assessment can provide additional useful information.
Collapse
Affiliation(s)
- Ayaz Hyder
- From the a School of Public Health, Yale University, New Haven, CT; bDepartment of Environmental Health, Harvard School of Public Health, Harvard University, Boston, MA; cand School of Forestry and Environmental Studies, Yale University, New Haven, CT
| | | | | | | | | | | |
Collapse
|
133
|
Kato T, Yorifuji T, Inoue S, Yamakawa M, Doi H, Kawachi I. Associations of preterm births with child health and development: Japanese population-based study. J Pediatr 2013; 163:1578-1584.e4. [PMID: 23968745 DOI: 10.1016/j.jpeds.2013.07.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Revised: 05/22/2013] [Accepted: 07/01/2013] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To examine associations between the duration of gestation and health and development outcomes at 2.5 years and 5.5 years using a Japanese population-based longitudinal survey (n = 47 015). STUDY DESIGN Hospitalization was used as an indicator of physical health, and responses to questions about age-appropriate behaviors were used as an indicator of behavioral development. We conducted logistic regression analyses controlling for a set of neonatal and family factors. We also estimated population-attributable fractions. RESULTS We observed a steady increase toward shorter duration of gestation in the risk of hospitalizations at age 2.5 years and 5.5 years and developmental delays at 2.5 years (Plinear trend < .001 for all outcomes). We found associations only between extremely preterm birth and delayed behavioral development at age 5.5 years. CONCLUSION There is a linear relationship between shorter duration of gestation and increased risk of later health and developmental problems. In line with Rose's "population paradox," the population-attributable risks for these problems are greater for moderately preterm infants compared with extremely preterm infants.
Collapse
Affiliation(s)
- Tsuguhiko Kato
- Department of Public Health and Public Policy, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | | | | | | | | | | |
Collapse
|
134
|
Abstract
Preterm delivery occurs in approximately 12% of all births in the United States and is a major factor that contributes to perinatal morbidity and mortality (). Preterm premature rupture of membranes (PROM) complicates approximately 3% of all pregnancies in the United States (). The optimal approach to clinical assessment and treatment of women with term and preterm PROM remains controversial. Management hinges on knowledge of gestational age and evaluation of the relative risks of delivery versus the risks of expectant management (eg, infection, abruptio placentae, and umbilical cord accident). The purpose of this document is to review the current understanding of this condition and to provide management guidelines that have been validated by appropriately conducted outcome-based research when available. Additional guidelines on the basis of consensus and expert opinion also are presented.
Collapse
|
135
|
Potijk MR, Kerstjens JM, Bos AF, Reijneveld SA, de Winter AF. Developmental delay in moderately preterm-born children with low socioeconomic status: risks multiply. J Pediatr 2013; 163:1289-95. [PMID: 23968750 DOI: 10.1016/j.jpeds.2013.07.001] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 06/04/2013] [Accepted: 07/01/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To assess separate and joint effects of low socioeconomic status (SES) and moderate prematurity on preschool developmental delay. STUDY DESIGN Prospective cohort study with a community-based sample of preterm- and term-born children (Longitudinal Preterm Outcome Project). We assessed SES on the basis of education, occupation, and family income. The Ages and Stages Questionnaire was used to assess developmental delay at age 4 years. We determined scores for overall development, and domains fine motor, gross motor, communication, problem-solving, and personal-social of 926 moderately preterm-born (MP) (32-36 weeks gestation) and 544 term-born children. In multivariable logistic regression analyses, we used standardized values for SES and gestational age (GA). RESULTS Prevalence rates for overall developmental delay were 12.5%, 7.8%, and 5.6% in MP children with low, intermediate, and high SES, respectively, and 7.2%, 4.0%, and 2.8% in term-born children, respectively. The risk for overall developmental delay increased more with decreasing SES than with decreasing GA, but the difference was not statistically significant: OR (95% CI) for a 1 standard deviation decrease were: 1.62 (1.30-2.03) and 1.34 (1.05-1.69), respectively, after adjustment for sex, number of siblings, and maternal age. No interaction was found except for communication, showing that effects of SES and GA are mostly multiplicative. CONCLUSIONS Low SES and moderate prematurity are separate risk factors with multiplicative effects on developmental delay. The double jeopardy of MP children with low SES needs special attention in pediatric care.
Collapse
Affiliation(s)
- Marieke R Potijk
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | | | | | | | | |
Collapse
|
136
|
D’Onofrio BM, Class QA, Rickert ME, Larsson H, Långström N, Lichtenstein P. Preterm birth and mortality and morbidity: a population-based quasi-experimental study. JAMA Psychiatry 2013; 70:1231-40. [PMID: 24068297 PMCID: PMC3823714 DOI: 10.1001/jamapsychiatry.2013.2107] [Citation(s) in RCA: 209] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Preterm birth is associated with increased mortality and morbidity. However, previous studies have been unable to rigorously examine whether confounding factors cause these associations rather than the harmful effects of being born preterm. OBJECTIVE To estimate the extent to which the associations between early gestational age and offspring mortality and morbidity are the result of confounding factors by using a quasi-experimental design, the sibling-comparison approach, and by controlling for statistical covariates that varied within families. DESIGN, SETTING, AND PARTICIPANTS A population-based cohort study, combining Swedish registries to identify all individuals born in Sweden from 1973 to 2008 (3,300,708 offspring of 1,736,735 mothers) and link them with multiple outcomes. MAIN OUTCOMES AND MEASURES Offspring mortality (during infancy and throughout young adulthood) and psychiatric (psychotic or bipolar disorder, autism, attention-deficit/hyperactivity disorder, suicide attempts, substance use, and criminality), academic (failing grades and educational attainment), and social (partnering, parenthood, low income, and social welfare benefits) outcomes through 2009. RESULTS In the population, there was a dose-response relationship between early gestation and the outcome measures. For example, extreme preterm birth (23-27 weeks of gestation) was associated with infant mortality (odds ratio, 288.1; 95% CI, 271.7-305.5), autism (hazard ratio [HR], 3.2; 95% CI, 2.6-4.0), low educational attainment (HR, 1.7; 1.5-2.0), and social welfare benefits (HR, 1.3; 1.2-1.5) compared with offspring born at term. The associations between early gestation and mortality and psychiatric morbidity generally were robust when comparing differentially exposed siblings and controlling for statistical covariates, whereas the associations with academic and some social problems were greatly or completely attenuated in the fixed-effects models. CONCLUSIONS AND RELEVANCE The mechanisms responsible for the associations between preterm birth and mortality and morbidity are outcome-specific. Associations between preterm birth and mortality and psychiatric morbidity are largely independent of shared familial confounds and measured covariates, consistent with a causal inference. However, some associations, particularly predicting suicide attempt, educational attainment, and social welfare benefits, are the result of confounding factors. The findings emphasize the importance of both reducing preterm birth and providing wraparound services to all siblings in families with an offspring born preterm.
Collapse
Affiliation(s)
- Brian M. D’Onofrio
- Indiana University-Bloomington, Department of Psychological and Brain Sciences,Correspondence regarding this article should be sent to: Brian D’Onofrio, Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th St., Bloomington, IN 47405, Phone: 812-856-0843, Fax: 812-856-4544,
| | - Quetzal A. Class
- Indiana University-Bloomington, Department of Psychological and Brain Sciences
| | - Martin E. Rickert
- Indiana University-Bloomington, Department of Psychological and Brain Sciences
| | - Henrik Larsson
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics
| | - Niklas Långström
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics
| | - Paul Lichtenstein
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics
| |
Collapse
|
137
|
Abstract
Late preterm (LP) infants are defined as those born at 34-0/7 to 36-6/7 weeks' gestational age. LP infants were previously referred to as near term infants. The change in terminology resulted from the understanding that these infants are not fully mature and that the last 6 weeks of gestation represent a critical period of growth and development of the fetal brain and lungs, and of other systems. There is accumulating evidence of higher risks for health complications in these infants, including serious morbidity and a threefold higher infant mortality rate compared with term infants. This information is of critical importance because of its scientific merits and practical implications. However, it warrants a critical and balanced review, given the apparent overall uncomplicated outcome for the majority of LP infants. Others reviewed the characteristics of LP infants that predispose them to a higher risk of morbidity at the neonatal period. This review focuses on the long-term neurodevelopmental and respiratory outcomes, with the main aim to suggest putative prenatal, neonatal, developmental, and environmental causes for these increased morbidities. It demonstrates parallelism in the trajectories of pulmonary and neurologic development and evolution as a model for fetal and neonatal maturation. These may suggest the critical developmental time period as the common pathway that leads to the outcomes. Disruption in this pathway with potential long-term consequences in both systems may occur if the intrauterine milieu is disturbed. Finally, the review addresses the practical implications on perinatal and neonatal care during infancy and childhood.
Collapse
Affiliation(s)
- Amir Kugelman
- Bnai Zion Medical Center, Department of Neonatology and Pediatric Pulmonary Unit, 47 Golomb Street, Haifa, 31048, Israel.
| | | |
Collapse
|
138
|
McDonald SW, Benzies KM, Gallant JE, McNeil DA, Dolan SM, Tough SC. A comparison between late preterm and term infants on breastfeeding and maternal mental health. Matern Child Health J 2013; 17:1468-77. [PMID: 23054457 PMCID: PMC3785180 DOI: 10.1007/s10995-012-1153-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
The objective of this study was to compare breastfeeding, postpartum mental health, and health service utilization between a group of late preterm (LP) maternal infant pairs and term counterparts. Data was drawn from a prospective community-based cohort in Calgary, Alberta. Bivariate and multivariable analyses were performed. LP infants were more likely to have had a longer median length of stay after birth (P < 0.001) and a higher re-hospitalization rate at 4-months (P < 0.001) compared to term infants. Mothers of LP infants were more likely to report immediate breastfeeding difficulties (P < 0.001) and earlier cessation of breastfeeding at 4-months postpartum (P = 0.008). Multivariable analyses revealed that LP status was an independent risk factor for excessive symptoms of maternal anxiety (OR = 2.07; 95 % CI = 1.08,3.98), but not for depression, stress, or low parenting morale. LP infants and their families are a vulnerable population with unique developmental trajectories. Further longitudinal research is required.
Collapse
Affiliation(s)
- Sheila W McDonald
- Department of Paediatrics, Faculty of Medicine, University of Calgary, Calgary, AB, Canada,
| | | | | | | | | | | |
Collapse
|
139
|
Maheshwari R, Trivedi A, Walker K, Holland AJA. Retrospective cohort study of long-gap oesophageal atresia. J Paediatr Child Health 2013; 49:845-9. [PMID: 23782058 DOI: 10.1111/jpc.12299] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2013] [Indexed: 12/13/2022]
Abstract
AIM Long-gap oesophageal atresia (LGOA) remains a rare variant of a relatively common congenital malformation. Objectives of this study were to review the short-term results including survival, length of stay and post-operative complications for infants with LGOA managed at a single centre in addition to their growth and neurodevelopmental assessment. METHODS Retrospective review of the case notes of all infants admitted with oesophageal atresia to our institution from January 2001 to May 2011. Infants with LGOA were selected based on pre-defined criteria. Demographic and clinical variables and details of follow-up visits including developmental assessments were extracted from their case notes. RESULTS Of 101 infants with oesophageal atresia, 15 fulfilled the criteria for LGOA. Overall survival was 80%. Median length of stay was 83 days. Additional congenital anomalies were present in nine (60%). A fall in weight centile during hospitalisation or outpatient follow-up signifying growth failure was seen in a majority with 11 of 13 patients showing this phenomenon. Follow-up at our institution ranged from 6 months to 9 years. Developmental assessments (Bayley-III) commenced in August 2006 were available in four patients (age 5-13 months) and were abnormal in all, with particular delay in the gross motor domain. CONCLUSIONS Infants with LGOA spend a long time in hospital. They remain at significant risk of growth failure during hospitalisation and following discharge. There appears to be a risk of developmental delay that warrants close monitoring.
Collapse
Affiliation(s)
- Rajesh Maheshwari
- Grace Centre for Newborn Care, The Children's Hospital, Sydney, New South Wales, Australia
| | | | | | | |
Collapse
|
140
|
Neonatal neurological examination of late preterm babies. Early Hum Dev 2013; 89:537-45. [PMID: 23380499 DOI: 10.1016/j.earlhumdev.2013.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 12/25/2012] [Accepted: 01/07/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUNDS Healthy late-preterm (LP) infants examined at term equivalent age showed wider median and range of neurological scores than full-term infants; differences between infants born at 34 and those born at 35-36 weeks were also observed. AIMS The aim of this study is to establish the range and frequency distribution of neonatal neurological scores in a cohort of low risk LP infants assessed during the first 3 days from birth. STUDY DESIGN AND SUBJECTS 118 low-risk infants born between 34 and 36 weeks of gestational age (GA) were assessed between 48 and 72 h from birth. OUTCOME MEASURES The full version of the Hammersmith Neonatal Neurologic Assessment and the screening proforma were used to assess all the infants. The raw scores obtained were compared to those of full-term infants using the same examination. RESULTS The distribution of neurological scores was similar among the 3 GAs for 26 items, with different median scores among LP infants born at 36 weeks and those born at 34 and 35 in only 2 items. LP infants showed a wider range of findings for each item than that of full term infants assessed soon after birth. Using the screening proforma, in our cohort, for each item the findings falling outside the 90% level were identical to those found in term-born and very preterm infants assessed at term age. CONCLUSIONS The neurological scores obtained in our cohort could help as reference data when examining LP infants at birth compared to age matched low risk infants.
Collapse
|
141
|
Maternal and pregnancy-related factors associated with developmental delay in moderately preterm-born children. Obstet Gynecol 2013; 121:727-733. [PMID: 23635671 DOI: 10.1097/aog.0b013e3182860c52] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To estimate the association between pre-existing maternal and pregnancy-related factors and developmental delay in early childhood in moderately preterm-born children. METHODS We measured development with the Ages and Stages Questionnaire at age 43-49 months in 834 moderately preterm-born (between 32 0/7 and 35 6/7 weeks of gestation) children born in 2002-2003. We obtained data on preexisting maternal, maternal pregnancy-related, fetal, and delivery-related factors. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) and attributable risks for developmental delay adjusted for sociodemographic and lifestyle variables. RESULTS Attributable risk for developmental delay for small-for-gestational-age (SGA, as a proxy for intrauterine growth restriction [IUGR]) was 14.2% (SGA 21.9%, no SGA 7.7%, P<.05, adjusted OR 2.75, CI 1.25-6.08), for preexisting maternal obesity 10.5% (obesity 18.0%, no obesity 7.5%, P<.01, adjusted OR 2.73, CI 1.35-5.52), for multiple pregnancy 4.2% (multiple 12.0%, singleton 7.8%, P<.05, adjusted OR 1.86, CI 1.02-3.42), and for male sex 9.3% (male 13.0%, female 3.8%, P<.001, adjusted OR 4.20, CI 2.09-8.46). No other preexisting or pregnancy-related maternal factors or any delivery-related factors were associated with increased risk of developmental delay. CONCLUSIONS Of all preexisting maternal and pregnancy-related factors studied, SGA, maternal prepregnancy obesity, being one of a multiple, and male sex were associated with the risk of developmental delay in early childhood after moderately preterm birth. Reinforced focus on prevention of IUGR, preconception lifestyle interventions aiming at weight reduction in fertile women, and reinforced efforts to reduce rates of multiple pregnancies in assisted reproduction may all contribute toward more favorable developmental outcomes in moderately preterm-born children. LEVEL OF EVIDENCE II.
Collapse
|
142
|
|
143
|
Early infant neuromotor assessment is associated with language and nonverbal cognitive function in toddlers: the Generation R Study. J Dev Behav Pediatr 2013; 34:326-34. [PMID: 23708382 DOI: 10.1097/dbp.0b013e3182961e80] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Numerous studies in high-risk populations established that variations in infant neuromotor development predict poor cognitive function. It is unclear whether this association is found in the general population. Moreover, previous population-based studies mostly focused on motor milestone achievement. METHODS This study was embedded in the Generation R Study, a population-based cohort in Rotterdam, the Netherlands. Neuromotor development was assessed with an adapted version of Touwen's Neurodevelopmental Examination when infants (1205 males, 1278 females) were on average 12 weeks old (standard deviation 1, range, 9-15 weeks). To measure language function at age 1.5 years, the MacArthur Short Form Vocabulary Checklist was used. At 2.5 years, mothers completed the Language Development Survey and the Parent Report of Children's Abilities measuring language and nonverbal cognitive functioning, respectively. RESULTS After adjustment for confounders, less optimal neuromotor development, that is, more low tone symptoms, was associated with a delay in receptive language at 1.5 years (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.05-1.34) and in expressive language at multiple time points (OR, 1.11; 95% CI, 1.02-1.21). Higher scores on overall neuromotor development, indicating a less optimal neuromotor development, was associated with an increased risk of a delay in nonverbal cognitive function at 2.5 years (OR, 1.19; 95% CI, 1.05-1.35). CONCLUSIONS The results of this study suggest that infants with more low tone symptoms, indicating minor deviances from normal neuromotor development, are somewhat more vulnerable to language delays than those infants who do not have these symptoms.
Collapse
|
144
|
Relations among upper-limb movement organization and cognitive function at school age in children born preterm. J Dev Behav Pediatr 2013; 34:344-52. [PMID: 23695270 DOI: 10.1097/dbp.0b013e318287ca68] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore relations between aspects of upper-body spatiotemporal movement organization and intelligence in children born preterm at school age. METHODS Three-dimensional (3D) kinematic recordings of arm and head movements during a unimanual precision task were related to performance on the Wechsler Intelligence Scale for Children, 4th edition, in a sample of 32 children born preterm (gestational age, mean: 31.5 weeks [range: 22-35 weeks]; birth weight, mean: 1699 g [range: 404-2962 g]) at 6 years to 8 years with no diagnosed cognitive, sensory, or motor impairments compared with 40 age-matched control children born fullterm. RESULTS In the children born preterm, upper-limb movement duration and segmentation of movement trajectories were significantly associated with full-scale intelligence quotient independent of gestational age (GA) and sex. These effects pertained to the preferred side, characterized by more effective movement organization being linked with increased intelligence scores. The same relations were not seen in the controls. Within the children born preterm, a significant effect of GA was also found for some aspects of upper-limb movement organization. Full-scale intelligence quotient was within normal limits for both groups but significantly lower in the preterm (mean: 94.5 [range: 72-120]) compared with the fullterm (mean: 101.7 [range: 76-119]) born children. CONCLUSIONS The findings demonstrate that, independent of GA, the spatiotemporal organization of upper-limb movements is partly associated with cognitive performance in children born preterm.
Collapse
|
145
|
Williams BL, Dunlop AL, Kramer M, Dever BV, Hogue C, Jain L. Perinatal origins of first-grade academic failure: role of prematurity and maternal factors. Pediatrics 2013; 131:693-700. [PMID: 23530177 DOI: 10.1542/peds.2012-1408] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We examined the relationships among gestational age at birth, maternal characteristics, and standardized test performance in Georgia first-grade students. METHODS Live births to Georgia-resident mothers aged 11 to 53 years from 1998 through 2003 were deterministically linked with standardized test results for first-grade attendees of Georgia public schools from 2005 through 2009. Logistic models were used to estimate the odds of failure of the 3 components of the first-grade Criterion-Referenced Competency Test (CRCT). RESULTS The strongest risk factor for failure of each of the 3 components of the first-grade CRCT was level of maternal education. Child race/ethnicity and maternal age at birth were also associated with first-grade CRCT failure irrespective of the severity of preterm birth, but these factors were more important among children born moderately preterm than for those born on the margins of the prematurity distribution. Adjusting for maternal and child characteristics, there was an increased odds of failure of each component of the CRCT for children born late preterm versus term, including for math (adjusted odds ratio [aOR]: 1.17, 95% confidence interval [CI]: 1.13-1.22), reading (aOR: 1.13, 95% CI: 1.08-1.18), and English/language arts, for which there was an important interaction with being born small for gestational age (aOR: 1.17, 95% CI: 1.07-1.29). CONCLUSIONS Preterm birth and low maternal education increase children's risk of failure of first-grade standardized tests. Promoting women's academic achievement and reduce rates of preterm birth may be important to achieving gains in elementary school performance.
Collapse
Affiliation(s)
- Bryan L Williams
- Nell Hodgson Woodruff School of Nursing, Rollins School of Public Health, Emory University, 1520 Clifton Rd NE, Atlanta, GA 30322, USA.
| | | | | | | | | | | |
Collapse
|
146
|
Lapillonne A, O'Connor DL, Wang D, Rigo J. Nutritional recommendations for the late-preterm infant and the preterm infant after hospital discharge. J Pediatr 2013; 162:S90-100. [PMID: 23445854 DOI: 10.1016/j.jpeds.2012.11.058] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Early nutritional support of preterm infants is critical to life-long health and well being. Numerous studies have demonstrated that preterm infants are at increased risk of mortality and morbidity, including disturbances in brain development. To date, much attention has focused on enhancing the nutritional support of very low and extremely low birth weight infants to improve survival and quality of life. In most countries, preterm infants are sent home before their expected date of term birth for economic or other reasons. It is debatable whether these newborns require special nutritional regimens or discharge formulas. Furthermore, guidelines that specify how to feed very preterm infants after hospital discharge are scarce and conflicting. On the other hand, the late-preterm infant presents a challenge to health care providers immediately after birth when decisions must be made about how and where to care for these newborns. Considering these infants as well babies may place them at a disadvantage. Late-preterm infants have unique and often-unrecognized medical vulnerabilities and nutritional needs that predispose them to greater rates of morbidity and hospital readmissions. Poor or inadequate feeding during hospitalization may be one of the main reasons why late-preterm infants have difficulty gaining weight right after birth. Providing optimal nutritional support to late premature infants may improve survival and quality of life as it does for very preterm infants. In this work, we present a review of the literature and provide separate recommendations for the care and feeding of late-preterm infants and very preterm infants after discharge. We identify gaps in current knowledge as well as priorities for future research.
Collapse
|
147
|
Dusing SC, Lobo MA, Lee HM, Galloway JC. Intervention in the first weeks of life for infants born late preterm: a case series. Pediatr Phys Ther 2013; 25:194-203. [PMID: 23542201 PMCID: PMC3621113 DOI: 10.1097/pep.0b013e3182888b86] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Infants born late preterm (34-36 weeks of gestation) account for 350 000 US births per year, are at risk for developmental delays, and are rarely included in intervention studies. PURPOSE To describe a novel parent-delivered movement intervention program for very young infants and outcomes following intervention and to evaluate the feasibility of using a comprehensive set of outcome measures. SUMMARY OF KEY POINTS Two infants born late preterm received intervention from 0.5 to 2.0 months of adjusted age. Development, postural control, reaching, and object exploration assessments were completed at 3 time points. The intervention was well tolerated by the family. Improvements in developmental outcomes, postural control, and object exploration are presented. STATEMENT OF CONCLUSION Very early movement experience provided daily by parents may improve development. In combination, norm-referenced and behavioral measures appear sensitive to changes in infant behaviors.
Collapse
Affiliation(s)
- Stacey C Dusing
- Motor Development Laboratory, Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
| | | | | | | |
Collapse
|
148
|
Tannock R. Rethinking ADHD and LD in DSM-5: proposed changes in diagnostic criteria. JOURNAL OF LEARNING DISABILITIES 2013; 46:5-25. [PMID: 23144062 DOI: 10.1177/0022219412464341] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is currently undergoing revision that will lead to a fifth edition (DSM-5) in 2013. This article first provides a brief synopsis of the DSM-5 administrative structure, procedures, and guiding principles to enhance understanding of how changes are made in the DSM. The next two sections (on attention-deficit/hyperactivity disorder and learning disorders, respectively) highlight the major concerns and controversies surrounding the DSM-IV diagnostic criteria for these two disorders and provide a rationale for the proposed changes to the criteria, along with a commentary on the empirical evidence on which the proposed changes were based.
Collapse
|
149
|
Kynø NM, Ravn IH, Lindemann R, Fagerland MW, Smeby NA, Torgersen AM. Effect of an early intervention programme on development of moderate and late preterm infants at 36 months: A randomized controlled study. Infant Behav Dev 2012; 35:916-26. [DOI: 10.1016/j.infbeh.2012.09.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 06/20/2012] [Accepted: 09/14/2012] [Indexed: 11/28/2022]
|
150
|
McGowan JE, Alderdice FA, Doran J, Holmes VA, Jenkins J, Craig S, Johnston L. Impact of neonatal intensive care on late preterm infants: developmental outcomes at 3 years. Pediatrics 2012; 130:e1105-12. [PMID: 23027176 DOI: 10.1542/peds.2012-0745] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Late preterm infants (LPIs) (34-36 weeks' gestation) account for up to 75% of preterm births and constitute a significant proportion of all neonatal admissions. This study assessed the impact of neonatal intensive or high-dependency care (IC) on developmental outcomes of LPIs at 3 years of age. METHODS This cohort study included 225 children born late preterm in Northern Ireland during 2006. Children born late preterm who received IC were compared with children born late preterm who did not receive IC. Cognitive, motor, and language skills were assessed by using the Bayley Scales of Infant and Toddler Development, Third Edition. Growth was assessed by using anthropometric measures of height and weight. RESULTS LPIs who received IC were more often less mature (34 weeks' gestation), with lower birth weight (≤ 2500 g) and Apgar scores (<7 at 5 minutes) compared with the control group. They were more often born by cesarean delivery and more likely to have received resuscitation at birth. At 3 years of age, children born late preterm who received IC demonstrated similar cognitive, motor, and language skills compared with children in the control group. Measurements of growth also did not differ significantly between groups. CONCLUSIONS Despite having increased maternal, perinatal, and neonatal risk factors, there were no significant differences in early childhood development between LPIs who received IC and those who did not. LPIs do not receive routine follow-up after IC and this study provides useful and reassuring data for parents and clinicians on the longer-term outcome of this infant group.
Collapse
Affiliation(s)
- Jennifer E McGowan
- School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Rd, Belfast BT9 7BL, UK.
| | | | | | | | | | | | | |
Collapse
|