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Picone S, Paolillo P. Neonatal outcomes in a population of late-preterm infants. J Matern Fetal Neonatal Med 2011; 23 Suppl 3:116-20. [PMID: 20822332 DOI: 10.3109/14767058.2010.509921] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The late-preterm infants are a group of premature steadily increasing, different from term infants as immature in terms of respiratory, metabolic, neurological, and immunological features. They may present at birth and during the first week of life various diseases and brain lesions echographically evident. We analyzed the neonatal outcomes of 417 late-preterm infants, born in our Department of Neonatology in a period of two and a half years, evaluating respiratory problems (RDS, transient tachypnea, pneumonia, pneumothorax, and apnea), metabolic problems (hypoglycemia, hypomagnesemia, hypo-hypernatremia, dehydration, hypocalcemia, and hyperbilirubinemia), infections, neurological symptoms associated with electrolyte disturbances, the disease patterns observed by ultrasound examination of the brain, the kidney ultrasound images, genital malformations.
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Affiliation(s)
- S Picone
- Department of Neonatology, Neonatal Intensive Care Unit, Casilino General Hospital, Rome, Italy
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202
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Hutton EK, Hannah ME, Ross SJ, Delisle MF, Carson GD, Windrim R, Ohlsson A, Willan AR, Gafni A, Sylvestre G, Natale R, Barrett Y, Pollard JK, Dunn MS, Turtle P. The Early External Cephalic Version (ECV) 2 Trial: an international multicentre randomised controlled trial of timing of ECV for breech pregnancies. BJOG 2011; 118:564-77. [PMID: 21291506 PMCID: PMC3085121 DOI: 10.1111/j.1471-0528.2010.02837.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objective To investigate whether initiating external cephalic version (ECV) earlier in pregnancy might increase the rate of successful ECV procedures, and be more effective in decreasing the rate of non-cephalic presentation at birth and of caesarean section. Design An unblinded multicentred randomised controlled trial. Setting A total of 1543 women were randomised from 68 centres in 21 countries. Population Women with a singleton breech fetus at a gestational age of 330/7 weeks (231 days) to 356/7 weeks (251 days) of gestation were included. Methods Participants were randomly assigned to having a first ECV procedure between the gestational ages of 340/7 (238 days) and 356/7 weeks of gestation (early ECV group) or at or after 370/7 (259 days) weeks of gestation (delayed ECV group). Main outcome measures The primary outcome was the rate of caesarean section; the secondary outcome was the rate of preterm birth. Results Fewer fetuses were in a non-cephalic presentation at birth in the early ECV group (314/765 [41.1%] versus 377/768 [49.1%] in the delayed ECV group; relative risk [RR] 0.84, 95% CI 0.75, 0.94, P = 0.002). There were no differences in rates of caesarean section (398/765 [52.0%] versus 430/768 [56.0%]; RR 0.93, 95% CI 0.85, 1.02, P = 0.12) or in risk of preterm birth (50/765 [6.5%] versus 34/768 [4.4%]; RR 1.48, 95% CI 0.97, 2.26, P = 0.07) between groups. Conclusion External cephalic version at 34–35 weeks versus 37 or more weeks of gestation increases the likelihood of cephalic presentation at birth but does not reduce the rate of caesarean section and may increase the rate of preterm birth.
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Affiliation(s)
- E K Hutton
- Department of Obstetrics and Gynecology (Midwifery), McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
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203
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Baron IS, Erickson K, Ahronovich MD, Baker R, Litman FR. Cognitive deficit in preschoolers born late-preterm. Early Hum Dev 2011; 87:115-9. [PMID: 21131147 DOI: 10.1016/j.earlhumdev.2010.11.010] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 11/10/2010] [Accepted: 11/16/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND late-preterm (LPT) birth accounts for a majority of preterm deliveries and until recently was considered low risk for poor cognitive outcome. Previously, we reported deficits in complicated LPT (cLPT) preschoolers (neonatal intensive care unit [NICU]-admitted). AIM to extend our prior study by comparing cognitive outcome in cLPT and uncomplicated LPT (uLPT; NICU non-admitted) preschoolers. STUDY DESIGN single center retrospective cohort study of 118 LPT children born in 2004-2006 at 35-36 weeks of gestation; 90 cLPT and 28 uLPT, compared with 100 term-born (≥ 37 weeks of gestation and ≥ 2500 g) participants. OUTCOME MEASURE a well-standardized measure of general conceptual ability (GCA), the Differential Ability Scales, Second Edition. RESULTS cLPT participants had average mean performances but significantly poorer GCA, Nonverbal Reasoning, and Spatial scores than term-born children, and higher rates of Nonverbal Reasoning and Spatial impairment; uLPT did not differ from TERM. Combined LPT males were at eightfold greater risk than term-born males for nonverbal deficit, and at sevenfold greater risk for GCA impairment than LPT females. CONCLUSIONS finding greater risk of cognitive deficit in those NICU-admitted due to clinical instability or birth weight < 2 kg compared with non-admitted preschoolers indicates that neonatal morbidities contribute to subtle cognitive deficits detectable at young age, with male gender an additive risk factor. LPT gestational age alone is an insufficient predictor of long-term neurocognitive outcome. Further study should elucidate salient etiologies for early emerging cognitive weaknesses and suggest appropriate interventions to prepare at-risk LPT preschoolers for elementary school entry.
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Affiliation(s)
- Ida Sue Baron
- Department of Pediatrics, Inova Fairfax Hospital for Children, Falls Church, VA, United States.
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204
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Souto A, Pudel M, Hallas D. Evidence-based care management of the late preterm infant. J Pediatr Health Care 2011; 25:44-9. [PMID: 21147407 DOI: 10.1016/j.pedhc.2010.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2010] [Revised: 03/01/2010] [Accepted: 04/07/2010] [Indexed: 10/19/2022]
Affiliation(s)
- Ana Souto
- New York University College of Nursing, New York, NY, USA
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205
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206
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Talge NM, Holzman C, Wang J, Lucia V, Gardiner J, Breslau N. Late-preterm birth and its association with cognitive and socioemotional outcomes at 6 years of age. Pediatrics 2010; 126:1124-31. [PMID: 21098151 DOI: 10.1542/peds.2010-1536] [Citation(s) in RCA: 191] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Late-preterm birth (34-36 weeks' gestation) has been associated with a risk for long-term cognitive and socioemotional problems. However, many studies have not incorporated measures of important contributors to these outcomes, and it is unclear whether effects attributed to gestational age are separate from fetal growth or its proxy, birth weight for gestational age. METHOD Data came from a study of low- and normal-weight births sampled from urban and suburban settings between 1983 and 1985 (low birth weight, n = 473; normal birth weight; n = 350). Random sampling was used to pair singletons born late-preterm with a term counterpart whose birth weight z score was within 0.1 SD of his or her match (n = 168 pairs). With random-effects models, we evaluated whether pairs differed in their IQ scores and teacher-reported behavioral problems at the age of 6 years. RESULTS In adjusted models, late-preterm birth was associated with an increased risk of full-scale (adjusted odds ratio [aOR]: 2.35 [95% confidence interval (CI): 1.20-4.61]) and performance (aOR: 2.04 [95% CI: 1.09-3.82]) IQ scores below 85. Late-preterm birth was associated with higher levels of internalizing and attention problems, findings that were replicated in models that used thresholds marking borderline or clinically significant problems (aOR: 2.35 [95% CI: 1.28-4.32] and 1.76 [95% CI: 1.04-3.0], respectively). CONCLUSIONS Late-preterm birth is associated with behavioral problems and lower IQ at the age of 6, independent of maternal IQ, residential setting, and sociodemographics. Future research is needed to investigate whether these findings result from a reduction in gestational length, in utero (eg, obstetric complications) or ex-utero (eg, neonatal complications) factors marked by late-preterm birth, or some combination of these factors.
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Affiliation(s)
- Nicole M Talge
- Department of Epidemiology, Michigan State University, B601 West Fee Hall, East Lansing, MI 48824, USA.
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207
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Romeo DM, Di Stefano A, Conversano M, Ricci D, Mazzone D, Romeo MG, Mercuri E. Neurodevelopmental outcome at 12 and 18 months in late preterm infants. Eur J Paediatr Neurol 2010; 14:503-7. [PMID: 20207178 DOI: 10.1016/j.ejpn.2010.02.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Revised: 02/10/2010] [Accepted: 02/10/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Late-preterms represent the 70% of the whole preterm population and are reported to be at higher risk for mortality and morbidity than term infants. AIMS To assess neurodevelopmental outcome in low-risk late-preterm infants at 12 and 18 months corrected age, to compare results of corrected and uncorrected age to those of term-born infants, to analyse the possible influence of gender on outcome. METHODS Sixty-one healthy infants born between 33 and 36 weeks gestational age without major brain lesions were assessed at 12 and 18 months corrected age using the Bayley II scale. A control group of 60 low-risk term born infants underwent the same assessment. RESULTS At 12 and 18 months corrected age late preterms showed a mean mental developmental index (MDI) similar to term infants. Comparing the results of the uncorrected age with term infants, the scores were significantly lower at both 12 and 18 months. No gender differences were observed in term-born infants, while male late-preterm infants showed lower MDI than peer females at both ages. CONCLUSIONS When correcting age for prematurity late-preterms have similar MDI scores to those obtained in term-born infants at 12 and 18 months. In contrast, when using chronological age there is a number of infants with low MDI. As cognitive abnormalities are reported at school age in late preterm infants, our findings raise the question on whether the results obtained using scores uncorrected for age may early identify the infants who will show cognitive difficulties at school age.
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Affiliation(s)
- Domenico M Romeo
- Division of Child Neurology and Psychiatry, Department of Paediatrics, University of Catania, Italy
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208
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Samra HA, McGrath JM, Wey H. Are former late-preterm children at risk for child vulnerability and overprotection? Early Hum Dev 2010; 86:557-62. [PMID: 20696540 DOI: 10.1016/j.earlhumdev.2010.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 07/03/2010] [Accepted: 07/13/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Parent perception of child vulnerability (PPCV) and parent overprotection (POP) are believed to have serious implications for age appropriate cognitive and psychosocial development in very low birth weight preterm children. AIM With recent concerns about suboptimal developmental outcomes in late-preterm children, this study was aimed at examining the relationship between history of late-preterm birth (34-36 6/7 weeks gestation), and PPCV, POP, and healthcare utilization (HCU). STUDY DESIGN This was a cross-sectional observational design. PARTICIPANTS Study participants were mothers of 54 healthy singleton children recruited from community centers including Women and Children Clinics (WIC), primary care clinics and daycare centers in the upper Midwest region. OUTCOME MEASURES Outcome measures included Forsyth Child Vulnerability Scale (CVS), Thomasgard Parent Protection Scale (PPS) scores, and healthcare utilization (HCU). Potential covariates included history of life-threatening illness, child and maternal demographics, and maternal stress and depression using the Center for Epidemiologic Studies Depression Scale (CESD). RESULTS HCU (p=0.02) and the PPS subscales of supervision (p=0.003) and separation (p=0.03) were significant predictors of PPCV in mothers of 3-8 years old children with late-preterm history. Age of the child (p=0.008) and CVS scores (p=0.005) were significant predictors of POP. Maternal age (p=0.04), stress (p=0.04), and CVS scores (p=0.003) were significant predictors of HCU. Dependence, a subscale of the PPS, correlated with the child's age and gender even after controlling for age. CONCLUSION History of late-preterm did not predict MPCV, MOP, or HCU in healthy children. Future research is needed in larger more diverse samples to better understand causal relationships and develop strategies to lessen risks of MPCV and MOP.
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Affiliation(s)
- Haifa A Samra
- South Dakota State University, College of Nursing, Brookings, SD 57007, United States.
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209
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Gurka MJ, LoCasale-Crouch J, Blackman JA. Long-term cognition, achievement, socioemotional, and behavioral development of healthy late-preterm infants. ACTA ACUST UNITED AC 2010; 164:525-32. [PMID: 20530302 DOI: 10.1001/archpediatrics.2010.83] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To compare healthy late-preterm infants with their full-term counterparts from age 4 through 15 years for numerous standard cognitive, achievement, socioemotional, and behavioral outcomes. DESIGN Prospective cohort study. SETTING National Institute of Child Health and Development Study of Early Child Care and Youth Development, 1991-2007. PARTICIPANTS A total of 1298 children (53 born at 34-36 weeks' gestational age), and their families, observed from birth through age 15 years. None of the infants had major health problems before or immediately following birth, and all the infants were discharged from the hospital within 7 days. MAIN EXPOSURE Preterm status: children born late preterm (34-36 weeks) vs those born full term (37-41 weeks). MAIN OUTCOME MEASURES Eleven standard outcomes measuring cognition, achievement, social skills, and behavioral/emotional problems using the Woodcock-Johnson Psycho-Educational Battery-Revised and the Child Behavior Checklist, administered repeatedly through age 15 years. RESULTS No consistent significant differences were found between late-preterm and full-term children for these standard measures from ages 4 to 15 years. Through age 15 years, the mean difference of most of these outcomes hovered around 0, indicating, along with small confidence intervals around these differences, that it is unlikely that healthy late-preterm infants are at any meaningful disadvantage regarding these measures. CONCLUSION Late-preterm infants born otherwise healthy seem to have no real burdens regarding cognition, achievement, behavior, and socioemotional development throughout childhood.
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Affiliation(s)
- Matthew J Gurka
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA 22908-0717, USA.
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210
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Kayem G, Haddad B. [Is it necessary to induce labor before 37 weeks of gestation in case of small for gestational age fetus?]. ACTA ACUST UNITED AC 2010; 38:496-9. [PMID: 20598618 DOI: 10.1016/j.gyobfe.2010.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The suspicion of small for gestational age fetus before 37 weeks of gestation implies to discriminate those who are physiologically small from those who have an underlying pathology leading to growth retardation. A labor induction can be needed if the risks associated to the prolongation of the pregnancy are estimated to be higher than those of prematurity and cesarean. In this case, labor induction can be discussed if the fetal vitality is normal. A continuous fetal heart monitoring during induction and labor is, in this case, strongly recommended. However, even in these optimal conditions, the risk of cesarean in case of labor induction for small for gestational age fetus before 37 weeks of gestation is of about 50 % in the rare published studies.
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Affiliation(s)
- G Kayem
- Service de gynécologie-obstétrique, centre hospitalier intercommunal de Créteil, université Paris XII, Créteil, France.
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211
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Abe K, Shapiro-Mendoza CK, Hall LR, Satten GA. Late preterm birth and risk of developing asthma. J Pediatr 2010; 157:74-8. [PMID: 20338577 DOI: 10.1016/j.jpeds.2010.01.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Revised: 10/21/2009] [Accepted: 01/06/2010] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the association between gestational age at birth (late preterm vs term) and risk for physician-diagnosed asthma. STUDY DESIGN We conducted a retrospective cohort study using the Third National Health and Nutrition Examination Survey (1988-1994) linked natality files. The study included children age 2-83 months from singleton births, born late preterm (n=537) or term (n=5650). Using survival analysis, we modeled time to diagnosis of asthma; children with no asthma diagnosis were censored at the age of their survey interview. We used Cox proportional hazard regression to estimate hazard ratios and 95% confidence intervals for gestational age and asthma risk, adjusting for maternal age, maternal education, parental history of asthma/hay fever, maternal smoking history during pregnancy, race/ethnicity, and sex of the child. RESULTS Adjusted analysis showed that physician-diagnosed asthma was modestly associated with late preterm birth (hazard ratio, 1.3; 95% confidence interval, 0.8-2.0), but this association was not statistically significant (P=.30). CONCLUSIONS Our study found that late preterm birth was not associated with a diagnosis of asthma in early childhood.
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Affiliation(s)
- Karon Abe
- Maternal and Infant Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3717, USA.
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212
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van Soelen ILC, Brouwer RM, Peper JS, van Beijsterveldt TCEM, van Leeuwen M, de Vries LS, Kahn RS, Hulshoff Pol HE, Boomsma DI. Effects of gestational age and birth weight on brain volumes in healthy 9 year-old children. J Pediatr 2010; 156:896-901. [PMID: 20227719 DOI: 10.1016/j.jpeds.2009.12.052] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Revised: 09/28/2009] [Accepted: 12/31/2009] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To assess the effects of gestational age and birth weight on brain volumes in a population-based sample of normal developing children at the age of 9 years. STUDY DESIGN A total of 192 children from twin births were included in the analyses. Data on gestational age and birth weight were reported shortly after birth. Total brain, cerebellum, cerebrum, gray and white matter, and lateral ventricle volumes were assessed with structural magnetic resonance imaging. The Wechsler Intelligence Scale for Children-III was administered to assess general cognitive abilities. Structural equation modeling was used to analyze the effects of gestational age and birth weight on brain volumes. RESULTS Shorter gestational age was associated with a relatively smaller cerebellar volume (P = .002). This effect was independent of IQ scores. Lower birth weight was associated with lower IQ score (P = .03). Birth weight was not associated with brain volumes. CONCLUSION The effect of gestational age on cerebellar volume is not limited to children with very premature birth or very low birth weight, but is also present in children born >32 weeks of gestation and with birth weight >1500 g.
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Affiliation(s)
- Inge L C van Soelen
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, the Netherlands; Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Rachel M Brouwer
- Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jiska S Peper
- Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Experimental Psychology, Utrecht University, Utrecht, the Netherlands
| | | | - Marieke van Leeuwen
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Linda S de Vries
- Department of Neonatology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - René S Kahn
- Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hilleke E Hulshoff Pol
- Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, the Netherlands
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213
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Champion V, Durrmeyer X, Dassieu G. Devenir respiratoire à court terme d’une population d’enfants nés à 34, 35 et 36 SA dans une maternité de niveau III. Arch Pediatr 2010; 17:19-25. [DOI: 10.1016/j.arcped.2009.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2008] [Revised: 09/06/2009] [Accepted: 10/08/2009] [Indexed: 10/20/2022]
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214
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Baron IS, Erickson K, Ahronovich MD, Coulehan K, Baker R, Litman FR. Visuospatial and verbal fluency relative deficits in 'complicated' late-preterm preschool children. Early Hum Dev 2009; 85:751-4. [PMID: 19879072 DOI: 10.1016/j.earlhumdev.2009.10.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 09/17/2009] [Accepted: 10/09/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Late-preterm children constitute a majority of all preterm deliveries (75%). Their immature brain development at birth has been associated with an increased risk for morbidities. Data have been sparse regarding neuropsychological outcomes in the preschool years. AIM To examine general cognition, attention/working memory, language, manual coordination/motor dexterity, visuomotor, visuospatial, and executive functions in preschoolers born late-preterm (LPT; 34-36 gestational weeks) who required NICU admission compared to term-born participants. DESIGN Single-center retrospective cohort study of 95 three-year-old children; 60 born LPT in 2004-2005 and admitted to the NICU compared to 35 healthy term-born participants born > or =37 gestational weeks and > or =2500 g. RESULTS LPT birth was associated with visuospatial (p=.005), visuomotor (p=.012), and executive function (noun [p=.018] and action-verb [p=.026] fluency) relative deficits, but not attention/working memory, receptive or expressive language, nonverbal reasoning, or manual coordination/dexterity deficit. CONCLUSIONS Late-preterm birth is likely to be associated with negative neuropsychological sequelae, although subtle and selective compared to effects reported for children born at an earlier gestational age. Visuospatial function appears to be especially vulnerable to disruption even at preschool age, and verbal fluency may be useful as an early predictor of executive dysfunction in childhood. Routine preschool neuropsychological evaluation is recommended to identify delay or deficit in LPT children preparing for school entry, and may highlight underlying vulnerable neural networks in LPT children.
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Affiliation(s)
- Ida Sue Baron
- Department of Pediatrics, Inova Fairfax Hospital for Children, 3300 Gallows Road, Falls Church, Virginia 22042, USA.
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215
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Dani C, Corsini I, Piergentili L, Bertini G, Pratesi S, Rubaltelli FF. Neonatal morbidity in late preterm and term infants in the nursery of a tertiary hospital. Acta Paediatr 2009; 98:1841-3. [PMID: 19604170 DOI: 10.1111/j.1651-2227.2009.01425.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- C Dani
- Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Florence, Italy.
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216
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Guglani L, Ryan RM, Lakshminrusimha S. Risk factors and management of transient tachypnea of the newborn. ACTA ACUST UNITED AC 2009. [DOI: 10.2217/phe.09.24] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Transient tachypnea of the newborn (TTN) is the consequence of delayed clearance of fetal lung liquid in the newborn. With recognition of the increased risk in babies born by Cesarean sections, epidemiologic association with maternal asthma and increasing research on the possible role of genetic polymorphisms of ion-channel subunits, our understanding of the pathophysiology of this condition has vastly improved. We now know that the late-preterm infant, born at 34–36 weeks gestation, is at increased risk for both TTN and respiratory distress syndrome due to surfactant deficiency. As the incidence of Cesarean sections rises, there is likelihood of increased respiratory morbidity in newborns that will necessitate additional medical interventions and exposure to complications of intensive care. This review focuses on the risk factors that are associated with the development of TTN and the treatment strategies that are employed for the management of this condition.
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Affiliation(s)
- Lokesh Guglani
- Division of Pediatric Pulmonology, Children’s Hospital of Pittsburgh, Children’s Hospital Drive, 45th St and Penn Avenue, Pittsburgh, PA 15201 USA
| | - Rita M Ryan
- Chief, Division of Neonatology, Professor of Pediatrics, Pathology & Anatomical Sciences, Gynecology-Obstetrics Director, Neonatal-Perinatal Medicine Fellowship Program, Director, Center for Developmental Biology of the Lung University at Buffalo, Women & Children’s Hospital of Buffalo 219 Bryant Street Buffalo, NY 14222-2006, USA
| | - Satyan Lakshminrusimha
- Associate Professor of Pediatrics, Division of Neonatology, Associate Program Director, Neonatal-Perinatal Medicine Fellowship Program, University at Buffalo, Women & Children’s Hospital of Buffalo, 219 Bryant Street, Buffalo, NY 14222-2006, USA
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