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Ballantyne M, Benzies KM, McDonald S, Magill-Evans J, Tough S. Risk of developmental delay: Comparison of late preterm and full term Canadian infants at age 12 months. Early Hum Dev 2016; 101:27-32. [PMID: 27405053 DOI: 10.1016/j.earlhumdev.2016.04.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 04/09/2016] [Accepted: 04/11/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Late preterm (34(0/7) to 36(6/7)weeks gestation) infants may experience developmental delays greater than those found in term (≥ 37(0/7)weeks gestation) infants. AIM The aim of this study was to compare the risk of developmental delay between late preterm and full-term Canadian born infants at age 12months, and to determine infant and maternal factors associated with risk of delay. METHODS A descriptive comparative study was conducted from data available from the All Our Babies community-based, prospective, pregnancy cohort in Calgary, Alberta. Participants were a sample of mothers of 52 infants born late preterm and 156 randomly selected mothers of term infants, matched for infant sex; eligible infants were singleton births. Mothers completed a developmental screening tool, the Ages and Stages Questionnaire, version 3 (ASQ-3), when their infant was age 12months. Corrected age (CA) was used for preterm infants. RESULTS Both late preterm and term infants who required neonatal intensive care (NICU) were more likely to demonstrate risk of developmental delay. Compared to term infants, there was a trend for late preterm infants to be at risk of communication and gross motor delay at age 12months CA that was attenuated to the null when adjustments were made for NICU admission and other covariates. CONCLUSIONS Infants born between 34 and 41weeks who are admitted to NICU are at increased risk of developmental delay. Early identification of risk provides an opportunity for referral for developmental assessment and early intervention programming.
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Affiliation(s)
- Marilyn Ballantyne
- Holland Bloorview Kids Rehabilitation Hospital, 2W305, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada.
| | - Karen M Benzies
- Faculty of Nursing, University of Calgary, PF2222, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada; Department of Paediatrics, Cumming School of Medicine, University of Calgary, 2888 Shaganappi Trail NW, Calgary, Alberta, T2N 4N1, Canada.
| | - Sheila McDonald
- Alberta Health Services, Calgary Zone, 10301 Southport Lane, SW, Calgary, Alberta, T2W 1S7, Canada.
| | - Joyce Magill-Evans
- Department of Occupational Therapy, 8205 - 114 Street, University of Alberta, Edmonton, Alberta, T6G 2G4, Canada.
| | - Suzanne Tough
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, 2888 Shaganappi Trail NW, Calgary, Alberta, T2N 4N1, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 2888 Shaganappi Trail NW, Calgary, Alberta, T2N 4N1, Canada.
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Lu L, Qu Y, Tang J, Chen D, Mu D. Risk factors associated with late preterm births in the underdeveloped region of China: A cohort study and systematic review. Taiwan J Obstet Gynecol 2016; 54:647-53. [PMID: 26700979 DOI: 10.1016/j.tjog.2014.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2014] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To determine factors associated with late preterm births in an underdeveloped region of China, and search for relevant reports in other underdeveloped regions by a systematic review. MATERIALS AND METHODS Data of births occurring between January 2004 and December 2008 from eight hospitals in Western Sichuan Province, China, were analyzed. Late preterm birth was defined as delivery at 34-36 6/7 weeks' gestation. Medline, Cochrane Library, and Google Scholar were searched for studies which reported the risk factors of late preterm births in undeveloped regions until January 31, 2014. RESULTS During the study period there were 4711 late preterm births and 54,574 term births. The odds ratios (ORs) for a late preterm birth of mothers < 20 years and ≥ 35 years of age were 3.813 [95% confidence interval (CI): 3.256-4.465] and 1.872 (95% CI: 1.677-2.090), respectively, as compared with an age of 20-34.9 years. Mothers who received prenatal care were less likely (OR = 0.623, 95% CI: 0.582-0.667) and those with a multiple gestation were more likely (OR = 9.346, 95% CI: 7.813, 11.236) to have a late preterm birth. The systematic review found that the incidence of late preterm births ranged from 4.4% to 16%, and the most prominent risk factors were eclampsia, preeclampsia, placenta previa, placental abruption, and twin pregnancy. CONCLUSION A number of factors are associated with late preterm births, and the incidence in underdeveloped regions is high. The inconsistent results between our study and previous reports indicate more attention towards preventing late preterm births in undeveloped regions is needed.
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Affiliation(s)
- Liqun Lu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yi Qu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Jun Tang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Dapeng Chen
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Dezhi Mu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.
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203
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Greene Z, O'Donnell CPF, Walshe M. Oral stimulation for promoting oral feeding in preterm infants. Cochrane Database Syst Rev 2016; 9:CD009720. [PMID: 27644167 PMCID: PMC6457605 DOI: 10.1002/14651858.cd009720.pub2] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Preterm infants (< 37 weeks' postmenstrual age) are often delayed in attaining oral feeding. Normal oral feeding is suggested as an important outcome for the timing of discharge from the hospital and can be an early indicator of neuromotor integrity and developmental outcomes. A range of oral stimulation interventions may help infants to develop sucking and oromotor co-ordination, promoting earlier oral feeding and earlier hospital discharge. OBJECTIVES To determine the effectiveness of oral stimulation interventions for attainment of oral feeding in preterm infants born before 37 weeks' postmenstrual age (PMA).To conduct subgroup analyses for the following prespecified subgroups.• Extremely preterm infants born at < 28 weeks' PMA.• Very preterm infants born from 28 to < 32 weeks' PMA.• Infants breast-fed exclusively.• Infants bottle-fed exclusively.• Infants who were both breast-fed and bottle-fed. SEARCH METHODS We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via PubMed (1966 to 25 February 2016), Embase (1980 to 25 February 2016) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to 25 February 2016). We searched clinical trials databases, conference proceedings and the reference lists of retrieved articles. SELECTION CRITERIA Randomised and quasi-randomised controlled trials comparing a defined oral stimulation intervention with no intervention, standard care, sham treatment or non-oral intervention in preterm infants and reporting at least one of the specified outcomes. DATA COLLECTION AND ANALYSIS One review author searched the databases and identified studies for screening. Two review authors screened the abstracts of these studies and full-text copies when needed to identify trials for inclusion in the review. All review authors independently extracted the data and analysed each study for risk of bias across the five domains of bias. All review authors discussed and analysed the data and used the GRADE system to rate the quality of the evidence. Review authors divided studies into two groups for comparison: intervention versus standard care and intervention versus other non-oral or sham intervention. We performed meta-analysis using a fixed-effect model. MAIN RESULTS This review included 19 randomised trials with a total of 823 participants. Almost all included trials had several methodological weaknesses. Meta-analysis showed that oral stimulation reduced the time to transition to oral feeding compared with standard care (mean difference (MD) -4.81, 95% confidence interval (CI) -5.56 to -4.06 days) and compared with another non-oral intervention (MD -9.01, 95% CI -10.30 to -7.71 days), as well as the duration of initial hospitalisation compared with standard care (MD -5.26, 95% CI -7.34 to -3.19 days) and compared with another non-oral intervention (MD -9.01, 95% CI -10.30 to -7.71 days).Investigators reported shorter duration of parenteral nutrition for infants compared with standard care (MD -5.30, 95% CI -9.73 to -0.87 days) and compared with another non-oral intervention (MD -8.70, 95% CI -15.46 to -1.94 days). They could identify no effect on breast-feeding outcomes nor on weight gain. AUTHORS' CONCLUSIONS Although the included studies suggest that oral stimulation shortens hospital stay, days to exclusive oral feeding and duration of parenteral nutrition, one must interpret results of these studies with caution, as risk of bias and poor methodological quality are high overall. Well-designed trials of oral stimulation interventions for preterm infants are warranted. Such trials should use reliable methods of randomisation while concealing treatment allocation, blinding caregivers to treatment when possible and paying particular attention to blinding of outcome assessors.
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Affiliation(s)
- Zelda Greene
- Our Lady's Children's HospitalSpeech and Language Therapy DepartmentCrumlinDublinIreland
| | - Colm PF O'Donnell
- National Maternity HospitalDepartment of NeonatologyHolles StreetDublin 2Ireland
| | - Margaret Walshe
- Trinity College DublinClinical Speech and Language Studies7‐9 South Leinster StreetDublinIreland2
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Abstract
With the advances of technology and treatment in the field of neonatal care, researchers can now study how the brains of preterm infants are different from full-term infants. The differences are significant, and the outcomes are poor overall for premature infants as a whole. Caregivers at the bedside must know that every interaction with the preterm infant affects brain development-it is critical to the developmental outcome of the infant. The idea of neuroprotection is not new to the medical field but is a fairly new idea to the NICU. Neuroprotection encompasses all interventions that promote normal development of the brain. The concept of brain-oriented care is a necessary extension of developmental care in the NICU. By following the journey of 26-week preterm twin infants through a case study, one can better understand the necessity of brain-oriented care at the bedside.
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205
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Shah P, Kaciroti N, Richards B, Oh W, Lumeng JC. Developmental Outcomes of Late Preterm Infants From Infancy to Kindergarten. Pediatrics 2016; 138:peds.2015-3496. [PMID: 27456513 PMCID: PMC4960722 DOI: 10.1542/peds.2015-3496] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To compare developmental outcomes of late preterm infants (34-36 weeks' gestation) with infants born at early term (37-38 weeks' gestation) and term (39-41 weeks' gestation), from infancy through kindergarten. METHODS Sample included 1000 late preterm, 1800 early term, and 3200 term infants ascertained from the Early Childhood Longitudinal Study, Birth Cohort. Direct assessments of development were performed at 9 and 24 months by using the Bayley Short Form-Research Edition T-scores and at preschool and kindergarten using the Early Childhood Longitudinal Study, Birth Cohort reading and mathematics θ scores. Maternal and infant characteristics were obtained from birth certificate data and parent questionnaires. After controlling for covariates, we compared mean developmental outcomes between late preterm and full-term groups in serial cross-sectional analyses at each timepoint using multilinear regression, with pairwise comparisons testing for group differences by gestational age categories. RESULTS With covariates controlled at all timepoints, at 9 months late preterm infants demonstrated less optimal developmental outcomes (T = 47.31) compared with infants born early term (T = 49.12) and term (T = 50.09) (P < .0001). This association was not seen at 24 months, (P = .66) but reemerged at preschool. Late preterm infants demonstrated less optimal scores in preschool reading (P = .0006), preschool mathematics (P = .0014), and kindergarten reading (P = .0007) compared with infants born at term gestation. CONCLUSIONS Although late preterm infants demonstrate comparable developmental outcomes to full-term infants (early term and full-term gestation) at 24 months, they demonstrate less optimal reading outcomes at preschool and kindergarten timepoints. Ongoing developmental surveillance for late preterm infants is warranted into preschool and kindergarten.
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Affiliation(s)
- Prachi Shah
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, School of Medicine, Center for Human Growth and Development, and
| | | | | | - Wonjung Oh
- Department of Human Development and Family Studies, College of Human Sciences, Texas Tech University, Lubbock, Texas
| | - Julie C. Lumeng
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, School of Medicine,,Center for Human Growth and Development, and,Department of Nutritional Sciences, School of Public of Health, University of Michigan, Ann Arbor, Michigan; and
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206
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Brumbaugh JE, Conrad AL, Lee JK, DeVolder IJ, Zimmerman MB, Magnotta VA, Axelson ED, Nopoulos PC. Altered brain function, structure, and developmental trajectory in children born late preterm. Pediatr Res 2016; 80:197-203. [PMID: 27064239 PMCID: PMC4990473 DOI: 10.1038/pr.2016.82] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 02/29/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Late preterm birth (34-36 wk gestation) is a common occurrence with potential for altered brain development. METHODS This observational cohort study compared children at age 6-13 y based on the presence or absence of the historical risk factor of late preterm birth. Children completed a battery of cognitive assessments and underwent magnetic resonance imaging of the brain. RESULTS Late preterm children (n = 52) demonstrated slower processing speed (P = 0.035) and scored more poorly in visual-spatial perception (P = 0.032) and memory (P = 0.007) than full-term children (n = 74). Parents of late preterm children reported more behavioral difficulty (P = 0.004). There were no group differences in cognitive ability or academic achievement. Imaging revealed similar intracranial volumes but less total tissue and more cerebrospinal fluid (P = 0.004) for late preterm children compared to full-term children. The tissue difference was driven by differences in the cerebrum (P = 0.028) and distributed across cortical (P = 0.051) and subcortical tissue (P = 0.047). Late preterm children had a relatively smaller thalamus (P = 0.012) than full-term children. Only full-term children demonstrated significant decreases in cortical tissue volume (P < 0.001) and thickness (P < 0.001) with age. CONCLUSION Late preterm birth may affect cognition, behavior, and brain structure well beyond infancy.
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Affiliation(s)
- Jane E. Brumbaugh
- (corresponding author) Stead Family Department of Pediatrics, University of Iowa, 200 Hawkins Drive, 8805 JPP, Iowa City, IA 52242, , Phone (w): 319-384-6231, Phone (c): 651-260-5035, Fax: 319-356-4685
| | - Amy L. Conrad
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Jessica K. Lee
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Ian J. DeVolder
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | | | | | - Eric D. Axelson
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Peggy C. Nopoulos
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA, USA
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Neurology, University of Iowa, Iowa City, IA, USA
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207
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Aliaga S, Zhang J, Long DL, Herring AH, Laughon M, Boggess K, Reddy UM, Grantz KL. Center Variation in the Delivery of Indicated Late Preterm Births. Am J Perinatol 2016; 33:1008-16. [PMID: 27120474 PMCID: PMC4972671 DOI: 10.1055/s-0036-1582129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective Evidence for optimal timing of delivery for some pregnancy complications at late preterm gestation is limited. The purpose of this study was to identify center variation of indicated late preterm births. Study design We performed an analysis of singleton late preterm and term births from a large U.S. retrospective obstetrical cohort. Births associated with spontaneous preterm labor, major congenital anomalies, chorioamnionitis, and emergency cesarean were excluded. We used modified Poisson fixed effects logistic regression with interaction terms to assess center variation of indicated late preterm births associated with four medical/obstetric comorbidities after adjusting for socio-demographics, comorbidities, and hospital/provider characteristics. Results We identified 150,055 births from 16 hospitals; 9,218 were indicated late preterm births. We found wide variation of indicated late preterm births across hospitals. The extent of center variation was greater for births associated with preterm premature rupture of membranes (risk ratio [RR] across sites: 0.45-3.05), hypertensive disorders of pregnancy (RR across sites: 0.36-1.27), and placenta previa/abruption (RR across sites: 0.48-1.82). We found less center variation for births associated with diabetes (RR across sites: 0.65-1.39). Conclusion Practice variation in the management of indicated late preterm deliveries might be a source of preventable late preterm birth.
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Affiliation(s)
- Sofia Aliaga
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC, Pediatrics CB#7596, 101 Manning Drive, Chapel Hill, NC 27599; ;
| | - Jun Zhang
- MOE-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 800 Dongchuan Rd., Minhang District, Shanghai, China;
| | - D. Leann Long
- Department of Biostatistics, West Virginia University, PO Box 9190, Morgantown, WV 26506;
| | - Amy H. Herring
- Department of Biostatistics, West Virginia University, PO Box 9190, Morgantown, WV 26506;
- Carolina Population Center, 206 West Franklin St., Rm. 208, Chapel Hill, NC 27516;
| | - Matthew Laughon
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC, Pediatrics CB#7596, 101 Manning Drive, Chapel Hill, NC 27599; ;
| | - Kim Boggess
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, The University of North Carolina, 101 Manning Drive, CB #7516, Old Clinic Building, Chapel Hill, NC 27599;
| | - Uma M. Reddy
- Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Blvd Room 7B03M, MSC 7510, Bethesda, MD 20852;
| | - Katherine Laughon Grantz
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 6100 Executive Blvd Room 7B03M, MSC 7510, Bethesda, MD 20852;
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208
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Postnatal growth standards for preterm infants: the Preterm Postnatal Follow-up Study of the INTERGROWTH-21(st) Project. LANCET GLOBAL HEALTH 2016; 3:e681-91. [PMID: 26475015 DOI: 10.1016/s2214-109x(15)00163-1] [Citation(s) in RCA: 214] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 06/23/2015] [Accepted: 07/27/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Charts of size at birth are used to assess the postnatal growth of preterm babies on the assumption that extrauterine growth should mimic that in the uterus. METHODS The INTERGROWTH-21(st) Project assessed fetal, newborn, and postnatal growth in eight geographically defined populations, in which maternal health care and nutritional needs were met. From these populations, the Fetal Growth Longitudinal Study selected low-risk women starting antenatal care before 14 weeks' gestation and monitored fetal growth by ultrasonography. All preterm births from this cohort were eligible for the Preterm Postnatal Follow-up Study, which included standardised anthropometric measurements, feeding practices based on breastfeeding, and data on morbidity, treatments, and development. To construct the preterm postnatal growth standards, we selected all live singletons born between 26 and before 37 weeks' gestation without congenital malformations, fetal growth restriction, or severe postnatal morbidity. We did analyses with second-degree fractional polynomial regression models in a multilevel framework accounting for repeated measures. Fetal and neonatal data were pooled from study sites and stratified by postmenstrual age. For neonates, boys and girls were assessed separately. FINDINGS From 4607 women enrolled in the study, there were 224 preterm singleton births, of which 201 (90%) were enrolled in the Preterm Postnatal Follow-up Study. Variance component analysis showed that only 0·2% and 4·0% of the total variability in postnatal length and head circumference, respectively, could be attributed to between-site differences, justifying pooling the data from all study sites. Preterm growth patterns differed from those for babies in the INTERGROWTH-21(st) Newborn Size Standards. They overlapped with the WHO Child Growth Standards for term babies by 64 weeks' postmenstrual age. INTERPRETATION Our data have yielded standards for postnatal growth in preterm infants. These standards should be used for the assessment of preterm infants until 64 weeks' postmenstrual age, after which the WHO Child Growth Standards are appropriate. Size-at-birth charts should not be used to measure postnatal growth of preterm infants. FUNDING Bill & Melinda Gates Foundation.
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209
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Extremely low birth weight babies grown up: Gene-environment interaction predicts internalizing problems in the third and fourth decades of life. Dev Psychopathol 2016; 29:837-843. [PMID: 27416920 DOI: 10.1017/s0954579416000511] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Extremely low birth weight (ELBW; <1000 g) infants have been exposed to stressful intrauterine and early postnatal environments. Even greater early adversity has been experienced by ELBW survivors who were also born small for gestational age (SGA; <10th percentile for GA) compared to those born appropriate for GA (AGA). ELBW survivors, particularly those born SGA, face increased risk for internalizing problems compared to normal BW (NBW; ≥2500 g) controls. Internalizing problems are related to allelic variations in the promoter region of the serotonin transporter linked polymorphic region gene (5-HTTLPR). We followed the oldest longitudinal cohort of ELBW survivors to adulthood. Participants provided buccal cells and reported on internalizing problems, using the Young Adult Self-Report when they were in their mid-20s (ELBW/SGA, N = 28; ELBW/AGA, N = 60; NBW, N = 81) and mid-30s (ELBW/SGA, N = 27; ELBW/AGA, N = 58; NBW, N = 76). The findings indicate that ELBW/SGAs carrying the 5-HTTLPR short allele reported increased internalizing problems, particularly depression, during the third and fourth decades of life. This is the first known report on gene-environment interactions predicting psychopathology among ELBW survivors. Our findings elucidate putative neurobiological pathways that underlie risk for psychopathology.
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210
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Heinonen K, Kajantie E, Pesonen AK, Lahti M, Pirkola S, Wolke D, Lano A, Sammallahti S, Lahti J, Andersson S, Eriksson JG, Raikkonen K. Common mental disorders in young adults born late-preterm. Psychol Med 2016; 46:2227-2238. [PMID: 27109930 DOI: 10.1017/s0033291716000830] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Results of adulthood mental health of those born late-preterm (34 + 0-36 + 6 weeks + days of gestation) are mixed and based on national registers. We examined if late-preterm birth was associated with a higher risk for common mental disorders in young adulthood when using a diagnostic interview, and if this risk decreased as gestational age increased. METHOD A total of 800 young adults (mean = 25.3, s.d. = 0.62 years), born 1985-1986, participated in a follow-up of the Arvo Ylppö Longitudinal Study. Common mental disorders (mood, anxiety and substance use disorders) during the past 12 months were defined using the Composite International Diagnostic Interview (Munich version). Gestational age was extracted from hospital birth records and categorized into early-preterm (<34 + 0, n = 37), late-preterm (34 + 0-36 + 6, n = 106), term (37 + 0-41 + 6, n = 617) and post-term (⩾42 + 0, n = 40). RESULTS Those born late-preterm and at term were at a similar risk for any common mental disorder [odds ratio (OR) 1.11, 95% confidence interval (CI) 0.67-1.84], for mood (OR 1.11, 95% CI 0.54-2.25), anxiety (OR 1.00, 95% CI 0.40-2.50) and substance use (OR 1.31, 95% CI 0.74-2.32) disorders, and co-morbidity of these disorders (p = 0.38). While the mental disorder risk decreased significantly as gestational age increased, the trend was driven by a higher risk in those born early-preterm. CONCLUSIONS Using a cohort born during the advanced neonatal and early childhood care, we found that not all individuals born preterm are at risk for common mental disorders in young adulthood - those born late-preterm are not, while those born early-preterm are at a higher risk. Available resources for prevention and intervention should be targeted towards the preterm group born the earliest.
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Affiliation(s)
- K Heinonen
- Institute of Behavioural Sciences, University of Helsinki,Helsinki,Finland
| | - E Kajantie
- National Institute for Health and Welfare,Helsinki,Finland
| | - A-K Pesonen
- Institute of Behavioural Sciences, University of Helsinki,Helsinki,Finland
| | - M Lahti
- Institute of Behavioural Sciences, University of Helsinki,Helsinki,Finland
| | - S Pirkola
- National Institute for Health and Welfare,Helsinki,Finland
| | - D Wolke
- Department of Psychology,University of Warwick,Coventry,UK
| | - A Lano
- Children's Hospital, Helsinki University Hospital and University of Helsinki,Helsinki,Finland
| | - S Sammallahti
- Institute of Behavioural Sciences, University of Helsinki,Helsinki,Finland
| | - J Lahti
- Institute of Behavioural Sciences, University of Helsinki,Helsinki,Finland
| | - S Andersson
- Children's Hospital, Helsinki University Hospital and University of Helsinki,Helsinki,Finland
| | - J G Eriksson
- National Institute for Health and Welfare,Helsinki,Finland
| | - K Raikkonen
- Institute of Behavioural Sciences, University of Helsinki,Helsinki,Finland
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Danzer E, Gerdes M, D'Agostino JA, Bernbaum J, Hoffman C, Herkert LM, Rintoul NE, Peranteau WH, Flake AW, Adzick NS, Hedrick HL. Younger gestational age is associated with increased risk of adverse neurodevelopmental outcome during infancy in congenital diaphragmatic hernia. J Pediatr Surg 2016; 51:1084-90. [PMID: 26831532 DOI: 10.1016/j.jpedsurg.2015.12.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 12/21/2015] [Accepted: 12/24/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND The purpose of the study was to investigate the impact of gestational age (GA) on short-term neurodevelopmental (ND) outcomes in congenital diaphragmatic hernia survivors. MATERIALS Between 6/2004 and 2/2013, 135 consecutive CDH patients underwent ND assessment using the Bayley Scales of Infant Development-III at a median follow-up age of 13months (range, 5-36). ND delay was defined by a score of ≤85 in any of the composite scales. Severe impairment was defined as a score of ≤69 in at least one domain. The effect of GA was evaluated as continuous and categorical variables. GA at delivery was grouped into full term (39-41weeks), near term (37-38), late preterm (34-36), and preterm (24-33). RESULTS Median GA at delivery was 38weeks (range, 24-41). Fifty (37%) patients were delivered full term, 59 (44%) near term, 16 (12%) late preterm, and 10 (7%) preterm. CDH children born before 39weeks' gestation were more likely to score below average (P=0.005) with corrected age for at least one composite score compared to full term peers. Cognitive (P=0.06) and language (P=0.08) scores tended to be lower in the near-term and late-preterm group compared to full-term CDH infants. Patients born near term and late preterm had significantly lower motor composite and fine motor scores compared to full-term children (P=0.009 and P<0.01, respectively). Preterm children scored the lowest in all composite scales (P<0.05). CONCLUSIONS Compared to term infants, not only preterm but also late preterm and near-term CDH children carry an increased risk of ND delays. Motor performance appears most susceptible to earlier delivery.
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Affiliation(s)
- Enrico Danzer
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
| | - Marsha Gerdes
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Jo Ann D'Agostino
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Judy Bernbaum
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Casey Hoffman
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Lisa M Herkert
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Natalie E Rintoul
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - William H Peranteau
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Alan W Flake
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - N Scott Adzick
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Holly L Hedrick
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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212
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Paliwoda M, New K, Bogossian F. Neonatal Early Warning Tools for recognising and responding to clinical deterioration in neonates cared for in the maternity setting: A retrospective case-control study. Int J Nurs Stud 2016; 61:125-35. [PMID: 27348358 DOI: 10.1016/j.ijnurstu.2016.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 06/09/2016] [Accepted: 06/14/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND All newborns are at risk of deterioration as a result of failing to make the transition to extra uterine life. Signs of deterioration can be subtle and easily missed. It has been postulated that the use of an Early Warning Tool may assist clinicians in recognising and responding to signs of deterioration earlier in neonates, thereby preventing a serious adverse event. OBJECTIVE To examine whether observations from a Standard Observation Tool, applied to three neonatal Early Warning Tools, would hypothetically trigger an escalation of care more frequently than actual escalation of care using the Standard Observation Tool. DESIGN A retrospective case-control study. SETTING A maternity unit in a tertiary public hospital in Australia. METHODS Neonates born in 2013 of greater than or equal to 34(+0) weeks gestation, admitted directly to the maternity ward from their birthing location and whose subsequent deterioration required admission to the neonatal unit, were identified as cases from databases of the study hospital. Each case was matched with three controls, inborn during the same period and who did not experience deterioration and neonatal unit admission. Clinical and physiological data recorded on a Standard Observation Tool, from time of admission to the maternity ward, for cases and controls were charted onto each of three Early Warning Tools. The primary outcome was whether the tool 'triggered an escalation of care'. Descriptive statistics (n, %, Mean and SD) were employed. RESULTS Cases (n=26) comprised late preterm, early term and post-term neonates and matched by gestational age group with 3 controls (n=78). Overall, the Standard Observation Tool triggered an escalation of care for 92.3% of cases compared to the Early Warning Tools; New South Wales Health 80.8%, United Kingdom Newborn Early Warning Chart 57.7% and The Australian Capital Territory Neonatal Early Warning Score 11.5%. Subgroup analysis by gestational age found differences between the tools in hypothetically triggering an escalation of care. CONCLUSIONS The Standard Observation Tool triggered an escalation of care more frequently than the Early Warning Tools, which may be as a result of behavioural data captured on the Standard Observation Tool and escalated, which could not be on the Early Warning Tools. Findings demonstrate that a single tool applied to all gestational age ranges may not be effective in identifying early deterioration or may over trigger an escalation of care. Further research is required into the sensitivity and specificity of Early Warning Tools in neonatal sub-populations.
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Affiliation(s)
- Michelle Paliwoda
- The University of Queensland, School of Nursing and Midwifery, UQ, Australia; The Royal Brisbane & Women's Hospital, Australia.
| | - Karen New
- The University of Queensland, School of Nursing and Midwifery, UQ, Australia; The Royal Brisbane & Women's Hospital, Australia; The University of Queensland, Centre for Clinical Research, Australia.
| | - Fiona Bogossian
- The University of Queensland, School of Nursing and Midwifery, UQ, Australia.
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213
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Matinolli HM, Männistö S, Sipola-Leppänen M, Tikanmäki M, Heinonen K, Lahti J, Lahti M, Wehkalampi K, Järvelin MR, Andersson S, Lano A, Vartia T, Wolke D, Eriksson JG, Vääräsmäki M, Räikkönen K, Kajantie E. Body image and eating behavior in young adults born preterm. Int J Eat Disord 2016; 49:572-80. [PMID: 27188543 DOI: 10.1002/eat.22553] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 03/16/2016] [Accepted: 03/22/2016] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Previous studies have suggested that people born preterm have increased rates of eating disorders (ED). However, a recent study suggested lower levels of ED-related symptoms in the extreme group of adults born preterm with very low birth weight (<1,500 g). We examined symptoms related to EDs in adults born early (<34 weeks of gestational age) or late (34 to <37 weeks of gestational age) preterm. METHODS We studied young adults (mean age 24.1 years) from two birth cohorts: ESTER (Northern Finland 1985-1989) and AYLS (Uusimaa, Finland, 1985-1986). Of the participants, 185 were born early preterm, 348 late preterm, and 637 were term-born controls (N = 1,170). They completed three subscales of the Eating Disorder Inventory (EDI)-2, including Drive for Thinness (DT), Body Dissatisfaction (BD), and Bulimia (B). Group differences were examined by linear regression. RESULTS Young women born early preterm scored 4.1 points (95% CI -8.0, -0.2, P =.04) lower in summed EDI subscale scores than women born at term, when adjusted for age and cohort. This difference was observed also in DT and BD but not for B subscales. The differences persisted after adjustments for current, pre- and neonatal characteristics. We did not observe differences in EDI scores among men or women born late preterm when compared to controls. DISCUSSION Women born early preterm have significantly fewer symptoms related to EDs in early adulthood when compared to their peers born at term, which may protect from developing an ED. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:572-580).
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Affiliation(s)
- Hanna-Maria Matinolli
- National Institute for Health and Welfare, Helsinki and Oulu, Finland.,Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Satu Männistö
- National Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Marika Sipola-Leppänen
- National Institute for Health and Welfare, Helsinki and Oulu, Finland.,Institute of Health Sciences, University of Oulu, Oulu, Finland.,PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marjaana Tikanmäki
- National Institute for Health and Welfare, Helsinki and Oulu, Finland.,Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Kati Heinonen
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland
| | - Jari Lahti
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.,Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
| | - Marius Lahti
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland
| | - Karoliina Wehkalampi
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Institute of Health Sciences, University of Oulu, Oulu, Finland.,Imperial College, London, United Kingdom
| | - Sture Andersson
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Aulikki Lano
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Timo Vartia
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Warwick, United Kingdom
| | - Johan G Eriksson
- National Institute for Health and Welfare, Helsinki and Oulu, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Marja Vääräsmäki
- National Institute for Health and Welfare, Helsinki and Oulu, Finland.,PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Katri Räikkönen
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki and Oulu, Finland.,PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland.,Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
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214
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Effects of breast-feeding compared with formula-feeding on preterm infant body composition: a systematic review and meta-analysis. Br J Nutr 2016; 116:132-41. [PMID: 27181767 DOI: 10.1017/s0007114516001720] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We conducted a systematic review and meta-analysis to compare the effect of breast-feeding and formula-feeding on body composition of preterm infants. We searched the literature using PubMed, Cochrane Central Library Issue, Ovid (Medline), Embase and other resources such as Google Scholar, electronic databases and bibliographies of relevant articles; two reviewers collected and extracted data independently. All the authors assessed risk of bias independently using the Newcastle-Ottawa Scale (NOS). A fixed-effects meta-analysis was undertaken with RevMan 5 software (The Cochrane Collaboration) using the inverse variance method (P≥0·05; χ 2 test). In contrast, a random-effects meta-analysis was carried out. Altogether, 630 articles were identified using search strategy, and the references within retrieved articles were also assessed. A total of six studies were included in this systematic review. In formula-fed infants, fat mass was higher at term (mean difference 0·24 (95 % CI 0·17, 0·31) kg), fat-free mass was higher at 36 weeks of gestational (mean difference 0·12 (95 % CI 0·04, 0·21) kg) and the percentage of fat mass was higher at 36 weeks of gestation (mean difference 3·70 (95 % CI 1·81, 5·59) kg) compared with breast-fed infants. Compared with breast-feeding, formula-feeding is associated with altered body composition from birth to term in preterm infants. The effects of formula-feeding on preterm infant body composition from term to 12-month corrected age are inconclusive in our study. Well-designed studies are required in the future to explore the effects of formula-feeding compared with breast-feeding.
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215
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Age-specific percentile-based reference curve of serum procalcitonin concentrations in Japanese preterm infants. Sci Rep 2016; 6:23871. [PMID: 27033746 PMCID: PMC4817150 DOI: 10.1038/srep23871] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 03/16/2016] [Indexed: 11/12/2022] Open
Abstract
Procalcitonin (PCT) levels are elevated early after birth in newborn infants; however, the physiological features and reference of serum PCT concentrations have not been fully studied in preterm infants. The aims of the current study were to establish an age-specific percentile-based reference curve of serum PCT concentrations in preterm infants and determine the features. The PCT concentration peaked in infants at 1 day old and decreased thereafter. At 1 day old, serum PCT concentrations in preterm infants <34 weeks’ gestational age were higher than those in late preterm infants between 34 and 36 weeks’ gestational age or term infants ≥37 weeks’ gestational age. Although the 50-percentile value in late preterm and term infants reached the adult normal level (0.1 ng/mL) at 5 days old, it did not in preterm infants. It took 9 weeks for preterm infants to reach it. Serum PCT concentrations at onset in late-onset infected preterm infants were over the 95-percentile value. We showed that the physiological feature in preterm infants was significantly different from that in late preterm infants, even in those <37 weeks’ gestational age. To detect late-onset bacterial infection and sepsis, an age-specific percentile-based reference curve may be useful in preterm infants.
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216
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Bulut C, Gürsoy T, Ovalı F. Short-Term Outcomes and Mortality of Late Preterm Infants. Balkan Med J 2016; 33:198-203. [PMID: 27403390 DOI: 10.5152/balkanmedj.2016.16721] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 10/27/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Late preterm infants have increased rates of morbidity and mortality compared to term infants. Determining the risk factors in these infants leads to more comprehensive preventive and treatment strategies. AIMS Our aim was to analyse the morbidity rates such as respiratory system diseases, infections, congenital anomalies, hypoglycemia and hematologic abnormalities and mortality rates in a large group of patients at a referral center. STUDY DESIGN Retrospective cross-sectional study. METHODS Medical records of late preterm and term infants who were managed at the referral center were analysed. RESULTS 41752 births were analysed in 3 years. 71.9% of all births were between 37-42 gestational weeks (i.e. term) and 16.1% were between 34-37 weeks (i.e. late preterm). Compared to term infants, late preterm infants had increased rates of short-term problems. The rate of mortality increased with decreased gestational age. The duration of hospitalization was significantly higher in the smallest late preterm infants. CONCLUSION This study demonstrated the need that late preterm infants who have higher risk for morbidity and mortality, compared to term infants require close monitoring. The rate of mortality and hospitalization increased with decreased gestational age.
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Affiliation(s)
- Cahide Bulut
- Neonatal Intensive Care Unit, Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, İstanbul, Turkey
| | - Tuğba Gürsoy
- Neonatal Intensive Care Unit, Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, İstanbul, Turkey
| | - Fahri Ovalı
- Neonatal Intensive Care Unit, Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, İstanbul, Turkey
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217
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Fratto VM, Ananth CV, Gyamfi-Bannerman C. Late preterm neonatal morbidity in hypertensive versus normotensive women. Hypertens Pregnancy 2016; 35:242-9. [PMID: 26930156 DOI: 10.3109/10641955.2016.1139720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE We estimated risks of late preterm (LP, 34°(/7)-36(6/7) weeks) delivery and neonatal respiratory and non-respiratory morbidity in women with mild and severe hypertension, in both low-risk and high-risk (history of chronic hypertension, preeclampsia (PE), or insulin-dependent diabetes in current pregnancy) cohorts. STUDY DESIGN This is a secondary analysis of two Maternal-Fetal Medicine Units Network randomized trials of aspirin to prevent PE. Women with non-anomalous singleton gestations delivered at ≥34 weeks were divided into three groups: normotensive, mild PE/gestational hypertension (GH), and severe PE/GH. Primary outcomes were respiratory (respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), or intubation) and non-respiratory (intraventricular hemorrhage, retinopathy of prematurity, small for gestational age (SGA) <10%, neonatal intensive care unit (NICU) admission, perinatal death, pulmonary hypertension, seizures, and 5 min Apgar <5) morbidity. Associations between LP delivery and risks of respiratory and non-respiratory morbidity were evaluated by fitting log-Binomial regression models before and after adjusting potential confounders. RESULTS Of 2781 women in the low-risk trial, mild and severe hypertension were diagnosed in 8.5% (n = 235) and 3.3% (n = 92), respectively. Respiratory morbidity was similar in all groups. Risks of non-respiratory morbidity were higher in the severe PE/GH group compared with normotensive women (28.3% vs. 16.8%, risk ratio 1.5, 95% confidence interval 1.1, 2.1). When restricting the analysis to late preterm infants, this risk was no longer present. Of the 1542 women in the high-risk trial, mild and severe hypertension were present in 16.6% (n = 256) and 11.9% (n = 184), respectively. Respiratory morbidity was again similar. Risks of non-respiratory morbidity were also not significantly increased in the high-risk cohort. CONCLUSION In both low- and high-risk women, mild PE/GH at ≥34 weeks is not associated with an increased risk of neonatal morbidity compared with normotensive women. Increased risk of composite neonatal morbidity related to severe PE/GH is confined to the subgroup of infants with non-respiratory morbidity, and disappears when including only late preterm infants.
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Affiliation(s)
- Victoria M Fratto
- a Department of Reproductive Medicine, Division of Perinatology , University of California , San Diego, San Diego , CA , USA
| | - Cande V Ananth
- b Department of Obstetrics and Gynecology , College of Physicians and Surgeons, Columbia University , New York , NY , USA.,c Department of Epidemiology , Mailman School of Public Health, Columbia University , New York , NY , USA
| | - Cynthia Gyamfi-Bannerman
- b Department of Obstetrics and Gynecology , College of Physicians and Surgeons, Columbia University , New York , NY , USA.,d Division of Maternal-Fetal Medicine , College of Physicians and Surgeons, Columbia University , New York , NY , USA
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218
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Odibo IN, Mac Bird T, McKelvey SS, Sandlin A, Lowery C, Magann EF. Childhood Respiratory Morbidity after Late Preterm and Early Term Delivery: a Study of Medicaid Patients in South Carolina. Paediatr Perinat Epidemiol 2016; 30:67-75. [PMID: 26480292 PMCID: PMC5373474 DOI: 10.1111/ppe.12250] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is a growing body of research documenting an increased risk of neonatal morbidity for late preterm infants (LPI, 34(0/7) weeks to 36(6/7) weeks) and early term infants (ETI, 37(0/7) weeks to 38(6/7) weeks) compared with term infants (TI, 39(0/7) to 41(6/7) ); however, there has been little research on outcomes beyond the first year of life. In this study, we examined respiratory outcomes of LPI and ETI in early childhood. METHODS South Carolina Medicaid claims data for maternal delivery and infant birth hospitalisations were linked to vital records data for the years 2000 through 2003. Medicaid claims for all infants were then followed until their fifth birthday or until a break in their eligibility. Infants born between 34(0/7) and 41(6/7) weeks were eligible. Infants with congenital anomaly, birthweight below 500 g or above 6000 g, and multiple births were excluded. We fit Cox proportional hazard models from which adjusted hazard ratio (HR) and 95% confidence interval (CI) were derived. RESULTS A total of 3476 LPI, 12 398 ETI, and 25 975 term infants were included. Both LPI and ETI were associated with an increased risk for asthma (LPI: HR 1.24, 95% CI 1.10, 1.40; ETI: HR 1.12, 95% CI 1.06, 1.19), and bronchitis (LPI: HR 1.15, 95% CI 1.00, 1.34; ETI: HR 1.13, 95% CI 1.05, 1.2) at 3 to 5 years of age. CONCLUSIONS Late preterm infants and early term infants are at increased risk for asthma and bronchitis.
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Affiliation(s)
- Imelda N. Odibo
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - T. Mac Bird
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Samantha S. McKelvey
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Adam Sandlin
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Curtis Lowery
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - E. F. Magann
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR
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219
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Kair LR, Colaizy TT. Breastfeeding Continuation Among Late Preterm Infants: Barriers, Facilitators, and Any Association With NICU Admission? Hosp Pediatr 2016; 6:261-8. [PMID: 27048247 DOI: 10.1542/hpeds.2015-0172] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Late preterm birth (at 34-36 6/7 weeks' gestation) is a risk factor for early breastfeeding cessation. The objective of this study was to determine barriers to and facilitators of breastfeeding continuation among late preterm infants (LPI) and to compare the barriers faced by LPI admitted to the well nursery versus the NICU. METHODS The SAS Complex Survey was used to perform multivariable logistic regression analysis by using data from the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System. Data from 3 states (Illinois, Maine, and Vermont) for the years 2004 to 2008 were used. RESULTS A total of 2530 mothers of LPI were surveyed. Odds of breastfeeding initiation were similar among LPI admitted to the NICU versus the well nursery (adjusted odds ratio, 1.24 [95% confidence interval, 0.88-1.73]; P = .209). Odds of breastfeeding for ≥ 10 weeks were no different between LPI admitted to the NICU versus those admitted to the well-nursery (adjusted odds ratio, 1.02 [95% confidence interval, 0.73-1.43]; P = .904). Factors associated with increased odds of breastfeeding for ≥ 10 weeks among LPI were higher maternal education, mother being married, and normal maternal BMI. Regardless of NICU admission, the top reasons cited by mothers of LPI for early breastfeeding discontinuation were perceived inadequate milk supply and nursing difficulties. CONCLUSIONS Among LPIs, NICU admission was not associated with early breastfeeding cessation. Mothers of LPIs with lower odds of sustaining breastfeeding for at least 10 weeks were single mothers, those with a high school education only, and those who were obese. Breastfeeding support should be enhanced for LPIs and should address perceived maternal milk supply concerns and nursing difficulties.
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Affiliation(s)
- Laura R Kair
- Department of Pediatrics, University of Iowa Stead Family, Carver College of Medicine, Iowa City, Iowa, 52242, USA.
| | - Tarah T Colaizy
- Department of Pediatrics, University of Iowa Stead Family, Carver College of Medicine, Iowa City, Iowa, 52242, USA
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220
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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.
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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
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221
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Giannì ML, Roggero P, Piemontese P, Liotto N, Orsi A, Amato O, Taroni F, Morlacchi L, Consonni D, Mosca F. Is nutritional support needed in late preterm infants? BMC Pediatr 2015; 15:194. [PMID: 26597280 PMCID: PMC4657334 DOI: 10.1186/s12887-015-0511-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 11/17/2015] [Indexed: 11/10/2022] Open
Abstract
Background Late preterm birth accounts for 70 % of all preterm births. While the impact of feeding problems in very preterm infants has been widely investigated, data on late preterm infants’ feeding issues are scarce. The aim of the present study was to investigate the need of nutritional support during hospital stay in a cohort of late preterm infants and to identify the factors that most contribute to its occurrence. Methods We analyzed the medical records of late preterm infants, born 2011–2013, admitted to a single institution. Neonatal data, the need for nutritional support, defined as the need for parenteral nutrition or intravenous fluids or tube feeding, and the feeding status at discharge were retrieved. The occurrence of respiratory distress syndrome, congenital malformations/chromosomal diseases, cardiac diseases, sepsis, hypoglycemia, poor feeding and the need for surgical intervention were also collected. Results A total of 1768 late preterm infants were included. Among the 592 infants requiring a nutritional support, 228 developed a respiratory distress syndrome, two developed a sepsis, one presented with a cardiac disease, 24 underwent a surgical intervention, eight had a chromosomal disease/congenital malformation, 80 had hypoglycemia. In addition, 100 infants required nutritional support due to poor feeding and 149 were born small for gestational age. Birth weight ≤2000 g (adjusted OR = 12.2, 95 % CI 7.5-19.9, p < 0.0001), gestational age of 34 weeks (adjusted OR = 4.08, 95 % CI 2.8-5.9, p < 0.0001), being small for gestational age (adjusted OR = 2.17, 95 % CI 2.8-5.9, p=0.001), having a respiratory distress syndrome (adjusted OR = 79.6, 95 % CI 47.2-134.3, p < 0.0001) and the need of surgical intervention (adjusted OR = 49.4, 95 % CI 13.9-174.5, p < 0.0001) were associated with a higher risk of need of nutritional support during hospital stay. Conclusions Late preterm infants are at relatively high risk of requiring nutritional support during hospital stay, especially if they have a birth weight ≤2000 g, a gestational age of 34 weeks, are born small for gestational age, develop a respiratory distress syndrome and require a surgical intervention. The present findings add to the knowledge of late preterm infants’ feeding issues and may contribute to tailoring nutritional approaches for these infants.
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Affiliation(s)
- Maria Lorella Giannì
- Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy.
| | - Paola Roggero
- Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy.
| | - Pasqua Piemontese
- Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy.
| | - Nadia Liotto
- Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy.
| | - Anna Orsi
- Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy.
| | - Orsola Amato
- Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy.
| | - Francesca Taroni
- Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy.
| | - Laura Morlacchi
- Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy.
| | - Dario Consonni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Epidemiology Unit, Via San Barnaba 8, 20122, Milan, Italy.
| | - Fabio Mosca
- Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy.
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Raffa L, Aring E, Dahlgren J, Karlsson AK, Andersson Grönlund M. Ophthalmological findings in relation to auxological data in moderate-to-late preterm preschool children. Acta Ophthalmol 2015; 93:635-41. [PMID: 26010319 DOI: 10.1111/aos.12763] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 04/11/2015] [Indexed: 12/21/2022]
Abstract
PURPOSE To evaluate ophthalmological findings in preschool children born moderate-to- late preterm (MLP) and relate the findings to auxological data at birth and at 5.5 years of age. METHODS Seventy-eight MLP children [gestational age (GA) 32-36 weeks; 34 girls; mean age 5.7 years] were investigated. Gestational age, weight, length and head circumference at birth and at the time of assessment were registered. Visual acuity (VA), refraction, orthoptic evaluation, slit-lamp examination and ophthalmoscopy were conducted, and a history of visuoperceptual problems was recorded. The data were compared with age- and sex-matched controls born full term (n = 35). RESULTS Ophthalmological abnormalities were noted in 82% of MLP children and 47% of controls (p = 0.0004). There was a significant difference with regard to impaired motility (p = 0.03), heterophoria at distance (p = 0.006) and refraction expressed as spherical equivalent dioptre (p = 0.01). Amongst auxological data at birth, birthweight (BW) was the strongest predictor to ophthalmological abnormalities (p = 0.0003). In a stepwise logistic regression, GA was the strongest predictor of VA outcome at time of assessment (p = 0.0036). Moderate-to-late preterm birth showed a 2.4-fold increased risk of refractive errors compared with full-term children (RR 2.39: 95% CI 1.10-5.20; p = 0.02). CONCLUSION Based on our findings, MLP birth may be associated with increased ocular morbidity compared with their full-term counterparts. Auxological data at birth, especially BW, seems to be an important factor when conducting an ophthalmological diagnosis in preschool MLP children, and an increased VA was correlated to a higher GA.
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Affiliation(s)
- Lina Raffa
- Institute of Neuroscience and Physiology/Ophthalmology; Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
- Department of Ophthalmology; King Abdulaziz University Hospital; Jeddah Saudi Arabia
| | - Eva Aring
- Institute of Neuroscience and Physiology/Ophthalmology; Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
| | - Jovanna Dahlgren
- Department of Pediatrics; Institute of Clinical Sciences; Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
| | - Ann-Katrine Karlsson
- Department of Pediatrics; Institute of Clinical Sciences; Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
| | - Marita Andersson Grönlund
- Institute of Neuroscience and Physiology/Ophthalmology; Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
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Schonhaut L, Pérez M, Muñoz S. Asociación entre morbilidad neonatal, edad gestacional y déficit de desarrollo psicomotor en prematuros moderados y tardíos. ACTA ACUST UNITED AC 2015; 86:415-25. [DOI: 10.1016/j.rchipe.2015.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 08/19/2015] [Accepted: 08/20/2015] [Indexed: 11/15/2022]
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Jang GJ. Comparing Factors Associated with Breastfeeding in Late Preterm Infants of Different Gestational Ages. CHILD HEALTH NURSING RESEARCH 2015. [DOI: 10.4094/chnr.2015.21.4.302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Baker B. Evidence-based practice to improve outcomes for late preterm infants. J Obstet Gynecol Neonatal Nurs 2015; 44:127-134. [PMID: 25782192 DOI: 10.1111/1552-6909.12533] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Infants born between 34 weeks 0 days to 36 weeks 6 days gestation have been identified as late preterm infants (LPIs) and account for 70% of preterm births and 9% of all births. The rise in elective deliveries in the past decade is believed to have contributed to the number of late preterm births. An interprofessional team including labor and delivery, neonatal intensive care, and postpartum care providers collaborated to address this issue at an urban academic medical center.
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Goyal NK, Folger AT, Hall ES, Ammerman RT, Van Ginkel JB, Pickler RS. Effects of home visiting and maternal mental health on use of the emergency department among late preterm infants. J Obstet Gynecol Neonatal Nurs 2015; 44:135-144. [PMID: 25782193 DOI: 10.1111/1552-6909.12538] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To describe use of the emergency department (ED) among late preterm versus term infants enrolled in a home visiting program and to determine whether home visiting frequency was associated with outcome differences. DESIGN Retrospective, cohort study. SETTING Regional home visiting program in southwest Ohio from 2007–2010. PARTICIPANTS Late preterm and term infants born to mothers enrolled in home visiting. Program eligibility requires ≥ one of four characteristics: unmarried, low income, < 18 years, or suboptimal prenatal care. METHODS Data were derived from vital statistics, hospital discharges, and home visiting records. Negative binomial regression was used to determine association of ED visits in the first year with late preterm birth and home visit frequency, adjusting for maternal and infant characteristics. RESULTS Of 1,804 infants, 9.2% were born during the late preterm period. Thirty-eight percent of all infants had at least one ED visit, 15.6% had three or more. No significant difference was found between the number of ED visits for late preterm and term infants (39.4% vs. 37.8% with at least one ED visit, p = .69). In multivariable analysis, late preterm birth combined with a maternal mental health diagnosis was associated with an ED incident rate ratio (IRR) of 1.26, p = .03; high frequency of home visits was not significant (IRR = .92, p = .42). CONCLUSIONS Frequency of home visiting service over the first year of life is not significantly associated with reduced ED visits for infants with at-risk attributes and born during the late preterm period. Research on how home visiting can address ED use, particularly for those with prematurity and maternal mental health conditions, may strengthen program impact and cost benefits.
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Patrick SW, Burke JF, Biel TJ, Auger KA, Goyal NK, Cooper WO. Risk of Hospital Readmission Among Infants With Neonatal Abstinence Syndrome. Hosp Pediatr 2015; 5:513-9. [PMID: 26427919 PMCID: PMC5110214 DOI: 10.1542/hpeds.2015-0024] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Neonatal abstinence syndrome (NAS) is a postnatal drug withdrawal syndrome that may last for months. Our objective was to determine if infants with NAS are at increased risk for hospital readmission compared with uncomplicated term and late preterm newborns. METHODS In this longitudinal retrospective cohort study, administrative data were used for all births from 2006 to 2009 in the New York State Inpatient Database. We identified infants with NAS, born late preterm or uncomplicated term, as independent groups using diagnostic codes and determined readmission rates. We fit a multivariable logistic regression model with 30-day readmission after discharge as the outcome and infant characteristics, clinical morbidities, insurance type, and length of birth hospitalization as predictors. RESULTS From 2006 to 2009 in New York State, 700 613 infants were classified as uncomplicated term, 51 748 were born late preterm, and 1643 infants were diagnosed with NAS. After adjusting for confounders, infants with NAS (odds ratio [OR] 2.49, 95% confidence interval [CI] 1.75-3.55) were more likely than uncomplicated term infants to be readmitted within 30 days of birth hospitalizations. The risk of readmission was similar to late preterm infants (OR 2.26, 95% CI 2.09-2.45). Length of birth hospitalization in days was inversely related to odds of being readmitted within 30 days of birth hospitalization (OR 0.94 95% CI 0.92-0.96). CONCLUSIONS When compared with uncomplicated term infants, infants diagnosed with NAS were more than twice as likely to be readmitted to the hospital. Future research and state-level policies should investigate means to mitigate risk of hospital readmission for infants with NAS.
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Affiliation(s)
- Stephen W Patrick
- Departments of Pediatrics, and Mildred Stahlman Division of Neonatology, Vanderbilt University, Nashville, Tennessee; Vanderbilt Center for Health Services Research, Nashville, Tennessee; Health Policy, and
| | | | - Terry J Biel
- School of Medicine, University of Michigan, Ann Arbor, Michigan; and
| | - Katherine A Auger
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
| | - Neera K Goyal
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
| | - William O Cooper
- Departments of Pediatrics, and Vanderbilt Center for Health Services Research, Nashville, Tennessee; Health Policy, and
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López Martínez A, Mantecón Fernández L, González Álvarez C, Arias Llorente R. Use of health care resources by late premature neonates in primary care. Case–control study in a health area. An Pediatr (Barc) 2015. [DOI: 10.1016/j.anpede.2015.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Helfrich AM, Nylund CM, Eberly MD, Eide MB, Stagliano DR. Healthy Late-preterm infants born 33-36+6 weeks gestational age have higher risk for respiratory syncytial virus hospitalization. Early Hum Dev 2015; 91:541-6. [PMID: 26186560 DOI: 10.1016/j.earlhumdev.2015.06.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 06/26/2015] [Accepted: 06/30/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a leading cause of hospitalization for children <1year old and is more severe in premature infants. OBJECTIVE To assess whether late preterm (LPT) birth is an independent risk factor for RSV hospitalization and more severe RSV disease in children less than 24months old. METHODS We conducted a retrospective cohort study of children enrolled in the military health system. LPT birth was defined as 33+0 through 36+6weeks gestation. Patients who received palivizumab or had known risk factors for RSV were excluded. Adjusted hazard ratios (HR) for LPT birth were calculated using a Cox proportional hazard model, while controlling for sex and RSV season. Severity of illness was assessed by comparing the need for respiratory support, length of stay, and age at RSV hospitalization between LPT and term children. RESULTS A total of 599,535 children for 1,216,382 person-years were studied, of which 7597 children were admitted for RSV infection. LPT infants accounted for 643 (8.5%) of these RSV hospitalizations. The incidence density for RSV hospitalization of LPT infants was higher than term children (12.1 vs 7.8 per 1000 person-years). LPT infants had an increased adjusted risk for RSV hospitalization; specifically, those born 33+0 through 34+6weeks (HR 2.45; 95% confidence interval (CI) 1.96-3.07), and 35+0 through 36+6weeks (HR, 1.92; 95% CI, 1.66-2.22). LPT infants had longer hospital stays and required more respiratory support than term children. CONCLUSIONS LPT birth is an independent risk factor for severe RSV disease and need for hospitalization.
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Affiliation(s)
- Alison M Helfrich
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD, USA; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Cade M Nylund
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Matthew D Eberly
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Matilda B Eide
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - David R Stagliano
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD, USA; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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López Martínez A, Mantecón Fernández L, González Álvarez C, Arias Llorente R. Consumo de recursos sanitarios en atención primaria de los prematuros tardíos. Estudio caso-control en un centro de salud urbano. An Pediatr (Barc) 2015; 83:213-5. [DOI: 10.1016/j.anpedi.2015.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/04/2015] [Accepted: 03/04/2015] [Indexed: 10/23/2022] Open
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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]
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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.
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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
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Thornton S, Miller H, Valenzuela G, Snidow J, Stier B, Fossler MJ, Montague TH, Powell M, Beach KJ. Treatment of spontaneous preterm labour with retosiban: a phase 2 proof-of-concept study. Br J Clin Pharmacol 2015; 80:740-9. [PMID: 25819462 DOI: 10.1111/bcp.12646] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 03/19/2015] [Accepted: 03/22/2015] [Indexed: 11/29/2022] Open
Abstract
AIM The aim was to investigate the efficacy and safety of intravenous retosiban in women with spontaneous preterm labour. METHODS This was a randomized, double-blind, placebo-controlled, phase 2 trial. Retosiban was administered intravenously for 48 h to women in spontaneous preterm labour between 30(0/7) and 35(6/7) weeks' gestation with an uncomplicated singleton pregnancy in an in-patient obstetric unit. Outcome measures were uterine quiescence (primary endpoint), days to delivery, preterm delivery and safety. RESULTS Uterine quiescence was achieved in 62% of women who received retosiban (n = 30) compared with 41% who received placebo (n = 34). The relative risk (RR) was 1.53 (95% credible interval [CrI] 0.98, 2.48; NS). Retosiban resulted in a significant increase in time to delivery compared with placebo (mean difference 8.2 days, 95% CrI 2.7, 13.74). This difference was consistent across all gestational ages. The proportion of preterm births in the retosiban and placebo groups was 18.7% (95% CrI 7.4%, 33.7%) and 47.2% (95% CrI 31.4%, 63.4%), respectively. The RR of preterm birth in women treated with retosiban was 0.38 (95% CrI 0.15, 0.81). There were no deliveries within 7 days in the retosiban group, but there were six (17.6%) births in the placebo group. The maternal, fetal and neonatal adverse events were comparable in the retosiban and placebo groups. CONCLUSIONS Intravenous administration of retosiban in women with spontaneous preterm labour was associated with a greater than 1 week increase in time to delivery compared with placebo, a significant reduction in preterm deliveries, a non-significant increase in uterine quiescence and a favourable safety profile.
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Affiliation(s)
| | - Hugh Miller
- Watching Over Mothers and Babies Foundation, Tucson, AZ, USA
| | | | - Jerry Snidow
- GlaxoSmithKline, Research Triangle Park, NC, USA
| | | | | | | | - Marcy Powell
- GlaxoSmithKline, Research Triangle Park, NC, USA
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Sipola-Leppänen M, Vääräsmäki M, Tikanmäki M, Matinolli HM, Miettola S, Hovi P, Wehkalampi K, Ruokonen A, Sundvall J, Pouta A, Eriksson JG, Järvelin MR, Kajantie E. Cardiometabolic risk factors in young adults who were born preterm. Am J Epidemiol 2015; 181:861-73. [PMID: 25947956 PMCID: PMC4445394 DOI: 10.1093/aje/kwu443] [Citation(s) in RCA: 167] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/09/2014] [Indexed: 11/16/2022] Open
Abstract
Adults who were born preterm with a very low birth weight have higher blood pressure and impaired glucose regulation later in life compared with those born at term. We investigated cardiometabolic risk factors in young adults who were born at any degree of prematurity in the Preterm Birth and Early Life Programming of Adult Health and Disease (ESTER) Study, a population-based cohort study of individuals born in 1985–1989 in Northern Finland. In 2009–2011, 3 groups underwent clinical examination: 134 participants born at less than 34 gestational weeks (early preterm), 242 born at 34–36 weeks (late preterm), and 344 born at 37 weeks or later (controls). Compared with controls, adults who were born preterm had higher body fat percentages (after adjustment for sex, age, and cohort (1985–1986 or 1987–1989), for those born early preterm, difference = 6.2%, 95% confidence interval (CI): 0.4, 13.2; for those born late preterm, difference = 8.0%, 95% CI: 2.4, 13.8), waist circumferences, blood pressure (for those born early preterm, difference = 3.0 mm Hg, 95% CI: 0.9, 5.1; for those born late preterm, difference = 1.7, 95% CI: −0.1, 3.4), plasma uric acid levels (for those born early preterm, difference = 20.1%, 95% CI: 7.9, 32.3; for those born late preterm, difference = 20.2%, 95% CI: 10.7, 30.5), alanine aminotransferase levels, and aspartate transaminase levels. They were also more likely to have metabolic syndrome (for those born early preterm, odds ratio = 3.7, 95% CI: 1.6, 8.2; for those born late preterm, odds ratio = 2.5, 95% CI: 1.2, 5.3). Elevated levels of conventional and emerging risk factors suggest a higher risk of cardiometabolic disease later in life. These risk factors are also present in the large group of adults born late preterm.
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Affiliation(s)
- Marika Sipola-Leppänen
- Correspondence to Dr. Marika Sipola-Leppänen, National Institute for Health and Welfare, P.O. Box 310, 90101 Oulu, Finland (e-mail: )
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Tolia VN, Patrick SW, Bennett MM, Murthy K, Sousa J, Smith PB, Clark RH, Spitzer AR. Increasing incidence of the neonatal abstinence syndrome in U.S. neonatal ICUs. N Engl J Med 2015; 372:2118-26. [PMID: 25913111 DOI: 10.1056/nejmsa1500439] [Citation(s) in RCA: 320] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The incidence of the neonatal abstinence syndrome, a drug-withdrawal syndrome that most commonly occurs after in utero exposure to opioids, is known to have increased during the past decade. However, recent trends in the incidence of the syndrome and changes in demographic characteristics and hospital treatment of these infants have not been well characterized. METHODS Using multiple cross-sectional analyses and a deidentified data set, we analyzed data from infants with the neonatal abstinence syndrome from 2004 through 2013 in 299 neonatal intensive care units (NICUs) across the United States. We evaluated trends in incidence and health care utilization and changes in infant and maternal clinical characteristics. RESULTS Among 674,845 infants admitted to NICUs, we identified 10,327 with the neonatal abstinence syndrome. From 2004 through 2013, the rate of NICU admissions for the neonatal abstinence syndrome increased from 7 cases per 1000 admissions to 27 cases per 1000 admissions; the median length of stay increased from 13 days to 19 days (P<0.001 for both trends). The total percentage of NICU days nationwide that were attributed to the neonatal abstinence syndrome increased from 0.6% to 4.0% (P<0.001 for trend), with eight centers reporting that more than 20% of all NICU days were attributed to the care of these infants in 2013. Infants increasingly received pharmacotherapy (74% in 2004-2005 vs. 87% in 2012-2013, P<0.001 for trend), with morphine the most commonly used drug (49% in 2004 vs. 72% in 2013, P<0.001 for trend). CONCLUSIONS From 2004 through 2013, the neonatal abstinence syndrome was responsible for a substantial and growing portion of resources dedicated to critically ill neonates in NICUs nationwide.
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Affiliation(s)
- Veeral N Tolia
- From the Division of Neonatology, Department of Pediatrics, Baylor University Medical Center, Pediatrix Medical Group (V.N.T.), and the Office of the Chief Quality Officer, Baylor Scott and White Health (M.M.B.) - all in Dallas; the Mildred Stahlman Division of Neonatology, Department of Pediatrics, and the Vanderbilt Center for Health Services Research and Department of Health Policy, Vanderbilt University School of Medicine, Nashville (S.W.P.); the Division of Neonatology, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, and Ann and Robert H. Lurie Children's Hospital of Chicago - both in Chicago (K.M.); the Department of Biomedical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton (J.S.), and the Center for Research, Education, and Quality, Mednax, Sunrise (R.H.C., A.R.S.) - both in Florida; the Department of Pediatrics, Duke University School of Medicine, Durham, NC (P.B.S.); and Pediatrix Medical Group, Greenville Memorial Hospital, Greenville, SC (R.H.C.)
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Meintjes I, Field S, Sanders L, van Heyningen T, Honikman S. Improving child outcomes through maternal mental health interventions. J Child Adolesc Ment Health 2015; 22:73-82. [PMID: 25859765 DOI: 10.2989/17280583.2010.528576] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This commentary will provide a general overview of the public health considerations of maternal mental illness, both from a global perspective as well as from the South African context. The paper will outline the consequences of maternal mental illness for mothers as well as their offspring, through the life stages from pregnancy until adulthood. The paper then describes the Perinatal Mental Health Project (PMHP), an intervention that addresses maternal mental health in Cape Town, South Africa. The evidence emerging from this example contributes to the case for integrating maternal mental health into the mainstream health environment.
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Affiliation(s)
- Ingrid Meintjes
- a Perinatal Mental Health Project, Department of Psychiatry and Mental Health , University of Cape Town , 46 Sawkins Road , Rondebosch , 7700 , Cape Town
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237
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Hodel AS, Brumbaugh JE, Morris AR, Thomas KM. Hot executive function following moderate-to-late preterm birth: altered delay discounting at 4 years of age. Dev Sci 2015; 19:221-34. [PMID: 25873181 DOI: 10.1111/desc.12307] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 02/18/2015] [Indexed: 01/08/2023]
Abstract
Interest in monitoring long-term neurodevelopmental outcomes of children born moderate-to-late preterm (32-36 weeks gestation) is increasing. Moderate-to-late preterm birth has a negative impact on academic achievement, which may relate to differential development of executive function (EF). Prior studies reporting deficits in EF in preterm children have almost exclusively assessed EF in affectively neutral contexts in high-risk preterm children (< 32 weeks gestation). Disrupted function in motivational or emotionally charged contexts (hot EF) following preterm birth remains uninvestigated, despite evidence that preterm children show differential development of neural circuitry subserving hot EF, including reduced orbitofrontal cortex volume. The present study is the first to examine whether low-risk, healthy children born moderate-to-late preterm exhibit impairments in the development of hot EF. Preterm children at age 4.5 years were less likely to choose larger, delayed rewards across all levels of reward magnitude on a delay discounting task using tangible rewards, but performed more similarly to their full-term peers on a delay aversion task involving abstract rewards and on measures of cool EF. The relationship between gestational age at birth and selection of delayed rewards extended across the entire gestational age range of the sample (32-42 weeks), and remained significant after controlling for intelligence and processing speed. Results imply that there is not a finite cut-off point at which children are spared from potential long-term neurodevelopmental effects of PT birth. Further investigation of reward processing and hot EF in individuals with a history of PT birth is warranted given the susceptibility of prefrontal cortex development to early environmental variations.
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Affiliation(s)
- Amanda S Hodel
- Institute of Child Development, University of Minnesota, USA
| | - Jane E Brumbaugh
- Stead Family Department of Pediatrics, University of Iowa Hospitals and Clinics, USA
| | - Alyssa R Morris
- Institute of Child Development, University of Minnesota, USA
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238
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Wang LK, Chen WM, Chen CP. Preterm birth trend in Taiwan from 2001 to 2009. J Obstet Gynaecol Res 2015; 40:1547-54. [PMID: 24888914 DOI: 10.1111/jog.12400] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 01/08/2014] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to analyze the trends and risk factors of preterm birth from all the women who delivered during 2001-2009 in Taiwan. MATERIAL AND METHODS We analyzed the preterm birth rates, the proportions of obstetric antecedents and risk factors in the population of pregnant women and neonatal Apgar scores according to the National Medical Birth Register database from 2001 to 2009. Adjusted odds ratios (OR) with 95% confidence intervals for risk factors of preterm birth were assessed using multivariable logistic regression models. The obstetric antecedents of preterm birth for singletons were stratified by spontaneous preterm labor and indicated preterm delivery (labor induction or elective cesarean delivery). RESULTS The preterm birth rate was 8.56% with the majority (89.76%) delivered between 32 and 37 weeks of gestation. A 0.07% annual increase (P < 0.001) in preterm delivery was observed. The greatest risk factors were multiple pregnancies (OR > 20), followed by medical complications (OR > 2.8), congenital malformations (OR > 2), teen pregnancies (OR > 1), and advanced maternal age (OR > 1). Specifically, singleton preterm births comprised 57.3% spontaneous labor and 42.7% indicated delivery. There was a 0.5% annual increase (P < 0.001) in indicated delivery. Incidence of neonates with poor Apgar scores (<7) was significantly different between those with and without medical complications (P < 0.001). CONCLUSIONS The preterm birth rate increased significantly from 2001 to 2009 and multiple pregnancies were the most important contributing factor. Most of the singleton preterm births resulted from spontaneous labor, but the proportion of indicated deliveries increased.
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Affiliation(s)
- Liang-Kai Wang
- Division of High Risk Pregnancy, Mackay Memorial Hospital
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239
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Abstract
Hospital discharge is a time of transition for infants and families that requires oversight of common postnatal adaptations, screening tests, and establishment of necessary follow-up care. Preterm infants face additional medical problems that vary in complexity by the degree of prematurity. Infants born at lowest gestational ages are at highest risks for complicated neonatal course and adverse long-term outcomes. Successful transition from hospital to home care is essential to improved outcomes for high-risk infants.
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Affiliation(s)
- Brian M Barkemeyer
- Neonatology, Louisiana State University Health Sciences Center, 200 Henry Clay Avenue, New Orleans, LA 70118, USA.
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240
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Healthy late preterm infants and supplementary artificial milk feeds: Effects on breast feeding and associated clinical parameters. Midwifery 2015; 31:426-31. [DOI: 10.1016/j.midw.2014.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 11/26/2014] [Accepted: 12/22/2014] [Indexed: 11/18/2022]
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241
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International Classification of Diseases, 10th Revision, Coding for Prematurity. Health Care Manag (Frederick) 2015; 34:123-7. [DOI: 10.1097/hcm.0000000000000053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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242
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Nagasaka M, Morioka I, Yokota T, Fujita K, Kurokawa D, Koda T, Shibata A, Yamada H, Ito Y, Uchino E, Shirai C, Iijima K. Incidence of short stature at 3 years of age in late preterm infants: a population-based study. Arch Dis Child 2015; 100:250-4. [PMID: 25260516 DOI: 10.1136/archdischild-2014-307045] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study aimed to investigate the incidence of short stature at 3 years of age in a Japanese cohort of late preterm infants who were born at 34-36 weeks' gestational age (GA). We compared these late preterm infants with term infants (37-41 weeks' GA), and evaluated the effect of birth weight on the incidence of short stature. METHODS A longitudinal population-based study of 26 970 neonates who were born between 34 weeks' and 41 weeks' GA in 2006-2008 was conducted in Kobe, Japan. Of these neonates, 1414 were late preterm and 25 556 were term infants. The late preterm infants were then divided into three subgroups based on birth weight as determined by Japanese neonatal anthropometric charts for GA at birth: large-for-GA (n=140), appropriate-for-GA (AGA, n=1083), and small-for-GA (SGA, n=191). The incidence of short stature at 3 years of age was calculated in the late preterm group and compared with that in the term group, and between the AGA and SGA groups with late preterm birth. RESULTS The incidence of short stature in the late preterm group was 2.9%, which was significantly higher than that in the term group (1.4%). Late preterm SGA infants developed short stature with a significantly higher (9.4%) incidence than that of late preterm AGA infants (2.1%). CONCLUSIONS The incidence of short stature in 3-year-old children who were late preterm infants has a 2-fold higher risk than that in term infants. The risk of developing short stature is increased 4.5-fold if they are SGA.
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Affiliation(s)
- Miwako Nagasaka
- Departments of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ichiro Morioka
- Departments of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoyuki Yokota
- Departments of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kaori Fujita
- Departments of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Kurokawa
- Departments of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tsubasa Koda
- Departments of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akio Shibata
- Departments of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hideto Yamada
- Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshiya Ito
- The Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
| | | | | | - Kazumoto Iijima
- Departments of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
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243
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Kair LR, Flaherman VJ, Newby KA, Colaizy TT. The experience of breastfeeding the late preterm infant: a qualitative study. Breastfeed Med 2015; 10:102-6. [PMID: 25647732 DOI: 10.1089/bfm.2014.0121] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Breastfeeding confers several health advantages to both infants and mothers. For reasons that are multifactorial, infants born even a few weeks prematurely are less likely to initiate breastfeeding, and those who breastfeed do so for a shorter duration than term infants. MATERIALS AND METHODS Qualitative analysis of structured telephone interviews was used to examine the breastfeeding experience of mothers of late preterm infants. RESULTS Our study found that, among mothers of late preterm infants, breastfeeding is both a positive bonding experience and a challenging experience, fraught with physical and medical struggles and feelings of guilt and failure. When looking back at the breastfeeding experience, many mothers recount negative experiences of milk supply concerns and breast pumping and report aspiring to be able to feed at breast more and pump less with their next child. CONCLUSIONS Mothers of late preterm infants reported that breastfeeding was a bonding experience for themselves and their infants, and many plan to do it again if they have future children. However, these mothers also reported that their breastfeeding experience included challenges with latching and milk supply, inadequate lactation support from providers after hospital discharge, and feelings of failure. Interventions with the potential to improve the breastfeeding experience of mothers of late preterm infants include (1) nipple shields and other devices to assist with latching, (2) hand expression or supplementation with small volumes of donor milk or formula to help limit the burden of pumping, (3) provider education to improve lactation support after hospital discharge, and (4) peer support groups.
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Affiliation(s)
- Laura R Kair
- 1 Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa , Iowa City, Iowa
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244
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Serpero LD, Pluchinotta F, Gazzolo D. The clinical and diagnostic utility of S100B in preterm newborns. Clin Chim Acta 2015; 444:193-8. [PMID: 25704302 DOI: 10.1016/j.cca.2015.02.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 02/06/2015] [Accepted: 02/14/2015] [Indexed: 11/18/2022]
Abstract
Preterm birth is still the most important cause of perinatal mortality and morbidity. Follow-up studies showed that the majority of neurological abnormalities during childhood are already present in the first week after birth. In this light, the knowledge of the timing of the insult and/or of the contributing factors is of utmost relevance in order to avoid adverse neurological outcome. Notwithstanding, the considerable advances in perinatal clinical care and monitoring, the early detection of cases at risk for brain damage is still a challenge because, when radiological pictures are still negative, brain damage may be already at a subclinical stage, with symptoms hidden by therapeutic strategies. Thus, it could be very relevant to measure quantitative parameters, such as neuroproteins, able to detect subclinical lesions at a stage when routine brain monitoring procedures are still silent. In the last decade, the assay of the brain-specific protein S100B in different biological fluids proved useful information on brain function and damage in the perinatal period. Therefore, the present study provides an overview of the most recent findings on S100B role as a reliable marker of brain development/damage in preterm high risk fetuses and newborns.
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Affiliation(s)
- Laura D Serpero
- Dept. of Maternal Fetal and Neonatal Medicine C. Arrigo Children's Hospital, Alessandria, Italy
| | - Francesca Pluchinotta
- Dept. of Pediatric Cardiovascular Surgery, IRCCS San Donato Milanese Hospital, San Donato Milanese, Italy
| | - Diego Gazzolo
- Dept. of Maternal Fetal and Neonatal Medicine C. Arrigo Children's Hospital, Alessandria, Italy.
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245
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Hoffenkamp HN, Braeken J, Hall RAS, Tooten A, Vingerhoets AJJM, van Bakel HJA. Parenting in Complex Conditions: Does Preterm Birth Provide a Context for the Development of Less Optimal Parental Behavior? J Pediatr Psychol 2015; 40:559-71. [DOI: 10.1093/jpepsy/jsv007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 01/14/2015] [Indexed: 11/14/2022] Open
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Davanzo R, De Cunto A, Paviotti G, Travan L, Inglese S, Brovedani P, Crocetta A, Calligaris C, Corubolo E, Dussich V, Verardi G, Causin E, Kennedy J, Marrazzo F, Strajn T, Sanesi C, Demarini S. Making the first days of life safer: preventing sudden unexpected postnatal collapse while promoting breastfeeding. J Hum Lact 2015; 31:47-52. [PMID: 25339551 DOI: 10.1177/0890334414554927] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Early and prolonged skin-to-skin contact (SSC) after birth between a mother and her newborn has been shown to generate beneficial effects on the mother-infant relationship and breastfeeding. Close mother-infant body contact immediately after birth positively enhances exclusive breastfeeding during the hospital stay, with a dose-response relationship. Skin-to-skin contact may ease the infant's transition to extra-uterine life and helps regulate the infant's body temperature and nursing behavior. However, reports of sudden unexpected postnatal collapse (SUPC) soon after birth, in healthy term neonates, in association with SSC, have raised concerns about the safety of this practice. Based on available evidence, we developed a surveillance protocol in the delivery room and postnatal ward of the Institute for Maternal and Child Health of Trieste (Italy). The aim of our protocol is (a) to promote safe mother and infant bonding and (b) to establish successful breastfeeding, without increasing the risk of SUPC. As there is no known effective intervention to prevent SUPC, our protocol has been conceived as a potential best practice.
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Affiliation(s)
- Riccardo Davanzo
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Angela De Cunto
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Giulia Paviotti
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Laura Travan
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Stefania Inglese
- Division of Obstetrics & Gynecology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Pierpaolo Brovedani
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Anna Crocetta
- Division of Pediatrics, San Polo Hospital, Monfalcone, Italy
| | | | - Elisa Corubolo
- Division of Obstetrics & Gynecology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Valentina Dussich
- Division of Obstetrics & Gynecology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Giuseppa Verardi
- Division of Obstetrics & Gynecology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Enrica Causin
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Jaquelyn Kennedy
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Francesca Marrazzo
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Tamara Strajn
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Cecilia Sanesi
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Sergio Demarini
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
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Gázquez Serrano I, Arroyos Plana A, Díaz Morales O, Herráiz Perea C, Holgueras Bragado A. Antenatal corticosteroid therapy and late preterm infant morbidity and mortality. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.anpede.2014.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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248
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McDonald SW, Kingston D, Bayrampour H, Dolan SM, Tough SC. Cumulative psychosocial stress, coping resources, and preterm birth. Arch Womens Ment Health 2014; 17:559-68. [PMID: 24948100 DOI: 10.1007/s00737-014-0436-5] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 06/11/2014] [Indexed: 01/27/2023]
Abstract
Preterm birth constitutes a significant international public health issue, with implications for child and family well-being. High levels of psychosocial stress and negative affect before and during pregnancy are contributing factors to shortened gestation and preterm birth. We developed a cumulative psychosocial stress variable and examined its association with early delivery controlling for known preterm birth risk factors and confounding environmental variables. We further examined this association among subgroups of women with different levels of coping resources. Utilizing the All Our Babies (AOB) study, an ongoing prospective pregnancy cohort study in Alberta, Canada (n = 3,021), multinomial logistic regression was adopted to examine the independent effect of cumulative psychosocial stress and preterm birth subgroups compared to term births. Stratified analyses according to categories of perceived social support and optimism were undertaken to examine differential effects among subgroups of women. Cumulative psychosocial stress was a statistically significant risk factor for late preterm birth (OR = 1.73; 95 % CI = 1.07, 2.81), but not for early preterm birth (OR = 2.44; 95 % CI = 0.95, 6.32), controlling for income, history of preterm birth, pregnancy complications, reproductive history, and smoking in pregnancy. Stratified analyses showed that cumulative psychosocial stress was a significant risk factor for preterm birth at <37 weeks gestation for women with low levels of social support (OR = 2.09; 95 % CI = 1.07, 4.07) or optimism (OR = 1.87; 95 % CI = 1.04, 3.37). Our analyses suggest that early vulnerability combined with current anxiety symptoms in pregnancy confers risk for preterm birth. Coping resources may mitigate the effect of cumulative psychosocial stress on the risk for early delivery.
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Affiliation(s)
- Sheila W McDonald
- Department of Paediatrics, University of Calgary, Calgary, AB, Canada,
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249
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Corticoterapia prenatal y morbimortalidad del prematuro tardío: estudio prospectivo. An Pediatr (Barc) 2014; 81:374-82. [DOI: 10.1016/j.anpedi.2014.01.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 01/20/2014] [Accepted: 01/27/2014] [Indexed: 01/08/2023] Open
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250
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Fatani T, Sharma AK, Weiler HA, Sheehy O, Bérard A, Rodd C. Differential low uptake of free vitamin D supplements in preterm infants: the Quebec experience. BMC Pediatr 2014; 14:291. [PMID: 25433491 PMCID: PMC4260192 DOI: 10.1186/s12887-014-0291-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 11/10/2014] [Indexed: 12/18/2022] Open
Abstract
Background Vitamin D is essential for bone mineralization, particularly in premature infants. For nearly 20 years, Quebec has offered a program of free vitamin D supplements via its public medication insurance plan Régie de l’Assurance Maladie du Québec (RAMQ). The objective of this study is to evaluate the number of preterm infants that obtained at least one bottle (50 doses) of vitamin D supplement through this program and to determine if uptake varied by gestational age. Methods This was a retrospective cohort study of preterm infants covered by RAMQ and born from 1998 to 2008; all infants had 1 year of follow-up data regarding supplement use. Data were extracted from the Quebec Pregnancy Cohort, a linked administrative database and were stratified by early (<34 weeks) or late gestational age premature infants. The number of infants obtaining supplements was the primary outcome and their characteristics were compared across gestational age groups. Predictors for participation (obtaining at least 1 bottle) or adherence (2 or more bottles) were identified via logistic regression (GEE). Results 10288 infants were eligible; the percentage exposed to vitamin D was 24.5% (37.4%- early; 20.7%-late preterm infants, p < 0.001). The median number of bottles obtained was 2 for early and 1 for late preterms. For all premature infants, there was an apparent geometric decline in the infants obtaining subsequent bottles of supplements over the 12 month period. Additionally, there was a significant decline in program participation over time (OR = 0.90/year, 95% CI: 0.89-0.90) regardless of gestational age. Older or more educated mothers were positive predictors for participation. A prescription from a pediatrician significantly increased the odds of obtaining the supplement. Conclusion Early preterm infants were more likely to obtain the supplement post-discharge; uptake was low and decreased with time for both age categories. Specifically, targeting late preterm infants and young mothers with less education could improve vitamin D uptake.
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