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Jung YJ, Cho HH. Changes in parents' health concerns by post-preterm birth period in South Korea: a cross-sectional study. CHILD HEALTH NURSING RESEARCH 2024; 30:118-128. [PMID: 38712461 PMCID: PMC11082501 DOI: 10.4094/chnr.2024.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/17/2024] [Accepted: 03/31/2024] [Indexed: 05/08/2024] Open
Abstract
PURPOSE This study aimed to examine the health concerns of parents regarding their premature infants and to identify changes in these concerns during perinatal period and after discharge. METHODS This was a retrospective study performed at a single tertiary center that enrolled 119 premature infants who were discharged from the neonatal intensive care unit (NICU) and visited the outpatient pediatrics department between December 2018 and October 2021. Data on the concerns of 176 parents regarding enrolled premature infants' health from before birth to 1 week after NICU discharge were obtained from outpatient records. The t test and with the chi-squared test were used to analyze the data for this study. RESULTS The consistently greatest focus of parents' health concerns was the respiratory system. The second focus of parents' health concerns before discharge was the central nervous system. However, during the first week after NICU discharge, the gastrointestinal system was the second-most frequent focus of parents' health concerns among parents of infants without diseases related to prematurity and infants with older gestational ages. CONCLUSION The results of this study offer insights into the health concerns among parents of premature infants. Parental health concerns about premature infants vary over time, from before birth to post-discharge, necessitating supportive interventions to enhance parental understanding of their child's health status.
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Affiliation(s)
- Yu Jin Jung
- Associate Professor, Department of Pediatrics, Kosin University College of Medicine, Busan, Korea
| | - Hun Ha Cho
- Associate Professor, College of Nursing, Kosin University, Busan, Korea
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Zhang J, Chen L, Yang Y, Liu X, Yuan Y, Song SR, Zhao Y, Mao J. Clinical and laboratory findings to differentiate late-onset sepsis caused by Gram-negative vs Gram-positive bacteria among perterm neonates: A retrospective cohort study. Int Immunopharmacol 2023; 116:109769. [PMID: 36716519 DOI: 10.1016/j.intimp.2023.109769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 01/29/2023]
Abstract
PURPOSE Late-onset sepsis (LOS) is a clinical condition that results in serious morbidity and mortality in preterm neonates. The aim of this study was to identify differences in clinical and laboratory findings of LOS caused by Gram-negative vs Gram-positive bacteria among perterm neonates and to evaluate the diagnostic accuracy of biomarkers. METHODS The retrospective cohort study included 649 preterm neonates with LOS assigned to either the Gram-positive group (n = 194, 29.89 %) or the Gram-negative group (n = 455, 70.11 %). Demographic data, serum levels of C-reactive protein (CRP), and complete blood counts at 0-24 h (T1), 24-48 h (T2), and 48-72 h (T3) were retrieved and compared. RESULTS At T1, T2, and T3, serum CRP levels were higher (p < 0.001), while platelet (PTL) counts were significantly lower (p < 0.001) in the Gram-negative group vs Gram-positive group. The area under the curve (AUC) of the PLT count was 0.688 (95 % confidence interval [CI] = 0.644-0.731) at T1, 0.795 (95 % CI = 0.743-0.848) at T2, and 0.785 (95 % CI = 0.739-0.831) at T3, indicating good discriminatory power, while the AUC of serum CRP was 0.654 (95 % CI = 0.61-0.697) at T1, 0.831 (95 % CI = 0.781-0.888) at T2, and 0.94 (95 % CI = 0.744-0.843) at T3. CONCLUSIONS Neonatal LOS caused by Gram-negative bacteria was associated with higher CRP and lower PLT levels. These results suggested that PLT and CRP values may be useful biomarkers to differentiate sepsis caused by Gram-negative vs Gram-positive bacteria among perterm neonates.
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Affiliation(s)
- Jing Zhang
- Department of Neonatology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China
| | - Ling Chen
- Department of Neonatology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China
| | - Yang Yang
- Department of Neonatology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China
| | - Xiao Liu
- Department of Neonatology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China
| | - Yuan Yuan
- Department of Neonatology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China
| | - Shi-Rong Song
- Department of Neonatology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China
| | - Yue Zhao
- Department of Neonatology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China
| | - Jian Mao
- Department of Neonatology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning 110004, China.
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Caporali C, Longo S, Tritto G, Perotti G, Pisoni C, Naboni C, Gardella B, Spinillo A, Manzoni F, Ghirardello S, Borgatti R, Orcesi S. Neurodevelopmental outcome of Italian preterm ELBW infants: an eleven years single center cohort. Ital J Pediatr 2022; 48:117. [PMID: 35854369 PMCID: PMC9297614 DOI: 10.1186/s13052-022-01303-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preterm extremely low birth weight infants (ELBWi) are known to be at greater risk of developing neuropsychiatric diseases. Identifying early predictors of outcome is essential to refer patients for early intervention. Few studies have investigated neurodevelopmental outcomes in Italian ELBWi. This study aims to describe neurodevelopmental outcome at 24 months of corrected age in an eleven-year single-center cohort of Italian ELBWi and to identify early risk factors for adverse neurodevelopmental outcomes. METHODS All infants born with birth weight < 1000 g and admitted to the Neonatal Intensive Care Unit of the "Fondazione IRCCS Policlinico San Matteo" hospital in Pavia, Italy, from Jan 1, 2005 to Dec 31, 2015 were eligible for inclusion. At 24 months, Griffiths' Mental Developmental Scales Extended Revised (GMDS-ER) were administered. Neurodevelopmental outcome was classified as: normal, minor sequelae (minor neurological signs, General Quotient between 76 and 87), major sequelae (cerebral palsy; General Quotient ≤ 75; severe sensory impairment). Univariate and multivariate multinomial logistic regression models were performed to analyze the correlation between neonatal variables and neurodevelopmental outcome. RESULTS 176 ELBWi were enrolled (mean gestational age 26.52 weeks sd2.23; mean birthweight 777.45 g sd142.89). 67% showed a normal outcome at 24 months, 17% minor sequelae and 16% major sequelae (4.6% cerebral palsy on overall sample). The most frequent major sequela was cognitive impairment (8.52%). In the entire sample the median score on the Hearing-Speech subscale was lower than the median scores recorded on the other subscales and showed a significantly weaker correlation to each of the other subscales of the GMDS-ER. Severely abnormal cUS findings (RRR 10.22 p 0.043) and bronchopulmonary dysplasia (RRR 4.36 p 0.008) were independent risk factors for major sequelae and bronchopulmonary dysplasia for minor sequelae (RRR 3.00 p 0.018) on multivariate multinomial logistic regression. CONCLUSIONS This study showed an improvement in ELBWI survival rate without neurodevelopmental impairment at 24 months compared to previously reported international cohorts. Cognitive impairment was the most frequent major sequela. Median scores on GMDS-ER showed a peculiar developmental profile characterized by a selective deficit in the language domain. Severely abnormal cUS findings and bronchopulmonary dysplasia were confirmed as independent risk factors for major sequelae.
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Affiliation(s)
- Camilla Caporali
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Stefania Longo
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giovanna Tritto
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.,Fondazione Stella Maris Mediterraneo, Chiaromonte, Potenza, Italy
| | - Gianfranco Perotti
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Camilla Pisoni
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Cecilia Naboni
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Barbara Gardella
- Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo and University of Pavia, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Arsenio Spinillo
- Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo and University of Pavia, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Federica Manzoni
- Biometry and Clinical Epidemiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Health Promotion - Environmental Epidemiology Unit, Hygene and Health Prevention Department, Health Protection Agency, Pavia, Italy
| | - Stefano Ghirardello
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Renato Borgatti
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Simona Orcesi
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
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Park JH, Lee H, Cho H. Analysis of the supportive care needs of the parents of preterm children in South Korea using big data text-mining: Topic modeling. CHILD HEALTH NURSING RESEARCH 2022; 27:34-42. [PMID: 35004495 PMCID: PMC8650870 DOI: 10.4094/chnr.2021.27.1.34] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/11/2020] [Accepted: 12/21/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose The purpose of this study was to identify the supportive care needs of parents of preterm children in South Korea using text data from a portal site. Methods In total, 628 online newspaper articles and 1,966 social network service posts published between January 1 and December 31, 2019 were analyzed. The procedures in this study were conducted in the following order: keyword selection, data collection, morpheme analysis, keyword analysis, and topic modeling. Results The term “yirundung-yi”, which is a native Korean word referring to premature infants, was confirmed to be a useful term for parents. The following four topics were identified as the supportive care needs of parents of preterm children: 1) a vague fear of caring for a baby upon imminent neonatal intensive care unit discharge, 2) real-world difficulties encountered while caring for preterm children, 3) concerns about growth and development problems, and 4) anxiety about possible complications. Conclusion Supportive care interventions for parents of preterm children should include general parenting methods for babies. A team composed of multidisciplinary experts must support the individual growth and development of preterm children and manage the complications of prematurity using highly accessible media.
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Affiliation(s)
- Ji Hyeon Park
- Graduate Student, Department of Nursing, Wonkwang University, Iksan, Korea
| | - Hanna Lee
- Graduate Student, Department of Nursing, Wonkwang University, Iksan, Korea
| | - Haeryun Cho
- Associate Professor, Department of Nursing, Wonkwang University, Iksan, Korea
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Nagy BE, Kenyhercz F. Adaptive Behavioral, Social-Emotional, and Neurodevelopmental Outcomes at 2 Years of Age in Hungarian Preterm Infants Based on Bayley III. Dev Neurorehabil 2021; 24:18-24. [PMID: 32420782 DOI: 10.1080/17518423.2020.1764651] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIM This study aimed to assess cognitive, language, and motor development as well as social-emotional and adaptive behavior skills of low birthweight (LBW) children. METHODS Our cohort contained 305 two-year-old LBW children. Developmental functioning was assessed by the Bayley Scales of Infant and Toddler Development, 3rd Edition. RESULTS Performance in language, particularly in expressive communication was the poorest. Extremely low birthweight (ELBW) children were found to be at increased risk of developmental delay: 12.73 times in motor (95%CI = 2.8-57.5), 9.81 times in cognitive (95%CI = 3.2-29.6) and 3.91 times in language (95%CI = 1.6-9.4), and social-emotional skills (95%CI = 1.6-9.5). Parents of children with lower birthweight reported poorer social and practical adaptive skills. Self-care domain seemed to be the least developed. CONCLUSION Additionally, the screening for developmental delays, monitoring the adaptive behavior skills may also be useful - especially among ELBW children - in order to identify the specific areas, situations, and functions that are most in need of interventions. ABBREVIATIONS AB: Adaptive Behavior; ABAS-II: Adaptive Behavior Assessment System-II; BPD: Bronchopulmonary Dysplasia; BSID-III: Bayley Scales of Infant Development 3rd Edition; BW: Birthweight; CI: Confidence Interval; CS: Composite Score; ELBW: Extremely Low Birthweight; GA: Gestational Age; IVF: In Vitro Fertilization; IVH: Intraventricular Hemorrhage; LBW: Low Birthweight; NEC: Necrotizing Enterocolitis; OR: Odds Ratio; ROP: Retinopathy of Prematurity; SE: Social-Emotional Development; VLBW: Very Low Birthweight.
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Affiliation(s)
- Beáta Erika Nagy
- Faculty of Medicine, Department of Pediatrics, Pediatric Psychology and Psychosomatic Unit, University of Debrecen , Debrecen, Hungary
| | - Flóra Kenyhercz
- Faculty of Medicine, Department of Pediatrics, Kálmán Laki Doctoral School, University of Debrecen , Debrecen, Hungary
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Lugli L, Bedetti L, Guidotti I, Pugliese M, Picciolini O, Roversi MF, DellaCasa Muttini E, Lucaccioni L, Bertoncelli N, Ancora G, Gargano G, Mosca F, Sandri F, Corvaglia LT, Solinas A, Perrone S, Stella M, Iughetti L, Berardi A, Ferrari F. Neuroprem 2: An Italian Study of Neurodevelopmental Outcomes of Very Low Birth Weight Infants. Front Pediatr 2021; 9:697100. [PMID: 34589450 PMCID: PMC8474877 DOI: 10.3389/fped.2021.697100] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Despite the increased survival of preterm newborns worldwide, the risk of neurodevelopmental disabilities remains high. Analyzing the outcomes of the preterm population can identify risk factors and enable specific early interventions. Aims: Neuroprem is a prospective cohort study of very low birth weight (VLBW) infants that aims to evaluate the neurodevelopmental outcomes and risk factors for severe functional disability at 2 years of corrected age. Methods: Nine Italian neonatal intensive care units participated in the network. The Griffiths Mental Developmental Scales (GMDS-R) or the Bayley Scales of Infant and Toddler Development (BSDI III) and a neuro-functional evaluation (according to the International Classification of Disability and Health and Neuro-Functional Assessment, or NFA ICF-CY) were administered to VLBW infants at 24 months of corrected age. The primary outcome measure was severe functional disability, defined as cerebral palsy, bilateral blindness, deafness, an NFA ICF-CY of >2, a BSDI III cognitive composite score of <2 SD, or a GMDS-R global quotient score of <2 SD. Perinatal risk factors for severe functional disability were assessed through multivariate logistic regression analysis. Results: Among 502 VLBW survivors who completed the 24-month follow-up, 48 (9.6%) presented severe functional disability, of whom 27 had cerebral palsy (5.4%). Rates of severe functional disability and cerebral palsy were higher in neonates with a lower gestational age (p < 0.001). Overall, 147 infants (29.3%) were referred to neuromotor intervention. In the multivariate regression model, gestational age at birth OR 0.79; 95% CI 0.67-0.90; p = 0.001) and periventricular-intraventricular hemorrhage (OR 2.51; 95% CI 1.19-5.26; p = 0.015) were significantly associated with severe functional disability. Conclusion: Neuroprem 2 provides updated information on the neurodevelopmental outcomes of VLBW infants in a large Italian cohort. The overall rate of neurodevelopmental disabilities was quite lower than reported in the previous literature. These data indicate the need for structured follow-up programs from a national neonatal network perspective.
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Affiliation(s)
- Licia Lugli
- Neonatal Intensive Care Unit, University Hospital of Modena, Modena, Italy
| | - Luca Bedetti
- Neonatal Intensive Care Unit, University Hospital of Modena, Modena, Italy.,PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Isotta Guidotti
- Neonatal Intensive Care Unit, University Hospital of Modena, Modena, Italy
| | - Marisa Pugliese
- Neonatal Intensive Care Unit, University Hospital of Modena, Modena, Italy.,Psychology Unit, University Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Odoardo Picciolini
- Physical and Rehabilitation Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | | | | | - Laura Lucaccioni
- Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Gina Ancora
- Neonatal Intensive Care Unit, Infermi Hospital of Rimini, Rimini, Italy
| | - Giancarlo Gargano
- Neonatal Intensive Care Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
| | - Fabio Mosca
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Fabrizio Sandri
- Neonatal Intensive Care Unit, Maggiore Hospital of Bologna, Bologna, Italy
| | - Luigi Tommaso Corvaglia
- Neonatal Intensive Care Unit, Sant'Orsola Malpighi University Hospital of Bologna, Bologna, Italy
| | - Agostina Solinas
- Neonatal Intensive Care Unit, Sant'Anna Hospital of Ferrara, Ferrara, Italy
| | - Serafina Perrone
- Neonatal Intensive Care Unit, University Hospital of Parma, Parma, Italy
| | - Marcello Stella
- Neonatal Intensive Care Unit, Bufalini Hospital of Cesena, Cesena, Italy
| | | | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.,Department of Medical and Surgical Sciences of Mothers, Children and Adults, Pediatric Postgraduate School, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Berardi
- Neonatal Intensive Care Unit, University Hospital of Modena, Modena, Italy
| | - Fabrizio Ferrari
- Neonatal Intensive Care Unit, University Hospital of Modena, Modena, Italy
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Pereira DG, Santos JN, Tsopanoglou SP, Lima MFR, Costa LBD, Morais RLS, Gomes WF, Oliveira VC. Environmental and personal factors that explain functional abilities and caregiver assistance on children aged 6 to 18 months: a cross-sectional study. MOTRIZ: REVISTA DE EDUCACAO FISICA 2021. [DOI: 10.1590/s1980-657420210000148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Daniel G Pereira
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brazil
| | - Juliana N Santos
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brazil
| | | | - Mylena FR Lima
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brazil
| | - Lucas B da Costa
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brazil
| | - Rosane LS Morais
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brazil
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Neurodevelopmental Outcome in Extremely Low Birth Weight Infants at 2-3 Years of Age. ACTA ACUST UNITED AC 2020; 56:medicina56120649. [PMID: 33256108 PMCID: PMC7760848 DOI: 10.3390/medicina56120649] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 11/17/2022]
Abstract
Background and objectives: The aims of this study were to examine the relationship between neurological outcomes at 3- and 6-months corrected age with the neurodevelopmental outcome at 3 years of age; to identify the perinatal/neonatal risk factors for poor neurodevelopmental outcomes at 3 years of age. Materials and methods: In our single-centre longitudinal cohort study, of the 73 consecutive infants admitted to our Neonatal Intensive Care Unit (NICU), 49 infants (80%) received both Hammersmith Infant Neurological Examination (HINE) at 3- and 6-months corrected age and Bayley–III neurodevelopmental assessment at 2–3 years chronological age. At 3 months follow up, 8.2% had suboptimal scores (below 10th percentile) on the HINE. At 6 months follow up, 4.1% had suboptimal scores (below 10th percentile) on the HINE. The means(±SD) for Bayley-III cognitive, language, and motor subscales were (96.3 ± 9.8), (99.9 ± 11.9), (93.2 ± 9.9). Results: At 3 months corrected age, higher total HINE scores and subscores for function of cranial nerves, posture, tone, were associated with better cognitive scores while poorer scores for function of cranial nerves, posture, movements, tone, and total HINE score were associated with lower motor scores. Infants with a HINE subscore of function of cranial nerves in the suboptimal range have three times higher odds of having a motor delay. Infants with a HINE subscore of function of cranial nerves in the suboptimal range have more than two times higher odds of having a language delay. At 6 months corrected age, poorer scores for function of cranial nerves, movements, tone, reflexes, and total HINE score were associated with worse Bayley-III motor scores whilst infants who have a total HINE score and a subscore of reflexes in the suboptimal range have four and seven times, respectively, higher odds of having a motor delay. Conclusions: Early identification of infants at risk for adverse long-term outcomes is essential in introducing early intervention therapies for optimizing neurodevelopmental outcomes.
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The Association between Delivery of Small-for-Gestational-Age Neonate and Their Risk for Long-Term Neurological Morbidity. J Clin Med 2020; 9:jcm9103199. [PMID: 33023204 PMCID: PMC7599795 DOI: 10.3390/jcm9103199] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/21/2020] [Accepted: 10/01/2020] [Indexed: 01/19/2023] Open
Abstract
Small-for-gestational-age (SGA) is defined as a birth weight below the 10th or below the 5th percentile for a specific gestational age and sex. Previous studies have demonstrated an association between SGA neonates and long-term pediatric morbidity. In this research, we aim to evaluate the possible association between small-for-gestational-age (SGA) and long-term pediatric neurological morbidity. A population-based retrospective cohort analysis was performed, comparing the risk of long-term neurological morbidities in SGA and non-SGA newborns delivered between the years 1991 to 2014 at a single regional medical center. The neurological morbidities included hospitalizations as recorded in hospital records. Neurological hospitalization rate was significantly higher in the SGA group (3.7% vs. 3.1%, OR = 1.2, 95% CI 1.1–1.3, p < 0.001). A significant association was noted between neonates born SGA and developmental disorders (0.2% vs. 0.1%, OR = 2.5, 95% CI 1.7–3.8, p < 0.001). The Kaplan-Meier survival curve demonstrated a significantly higher cumulative incidence of neurological morbidity in the SGA group (log-rank p < 0.001). In the Cox proportional hazards model, which controlled for various Confounders, SGA was found to be an independent risk factor for long-term neurological morbidity (adjusted hazard ratio( HR) = 1.18, 95% CI 1.07–1.31, p < 0. 001). In conclusion, we found that SGA newborns are at an increased risk for long-term pediatric neurological morbidity.
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Liu HQ, Tong XM. [A clinical analysis of late-onset sepsis in very low birth weight and extremely low birth weight infants]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:1038-1043. [PMID: 31642441 PMCID: PMC7389729 DOI: 10.7499/j.issn.1008-8830.2019.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/17/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To study the clinical features and pathogenic bacteria of late-onset sepsis (LOS) in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants. METHODS Among the VLBW/ELBW infants with a gestational age of <32 weeks who were admitted to the hospital between January 2012 and December 2016, those with LOS were enrolled as the LOS group, and those without sepsis were matched for the infant with LOS in gestational age were enrolled as the control group. According to the presence or absence of in-hospital death, the LOS group was further divided into a death subgroup and a survival subgroup. Risk factors for LOS, clinical features, distribution of pathogenic bacteria, drug resistance, and high-risk factors for LOS-related death were analyzed. RESULTS A total of 513 VLBW/ELBW infants were enrolled, and there were 65 infants in the LOS group and 130 in the control group. The incidence rate of LOS was 12.7%. In the LOS group, 6 infants died and 59 survived. Compared with the control group, the LOS group had a significantly lower birth weight (P<0.05) and significantly longer indwelling time of peripherally inserted central catheter (PICC), duration of mechanical ventilation, and length of hospital stay (P<0.05). Compared with the control group, the LOS group had a significantly higher proportion of small-for-gestational-age infants, infants undergoing mechanical ventilation, infants with neonatal necrotizing enterocolitis, or infants who died (P<0.05). Low birth weight, small-for-gestational-age infant, and long indwelling time of PICC were independent risk factors for LOS in VLBW/ELBW infants (OR=1.396, 2.550, and 1.068 respectively, P<0.05). Purulent meningitis was an independent risk factor for LOS-related death in VLBW/ELBWIs infants (OR=13.443, P<0.05). A total of 65 strains of pathogenic bacteria were cultured in the LOS group, among which there were 39 strains (60%) of Gram-negative bacteria, including 15 strains producing extended spectrum beta-lactamases (ESBLs), and antibiotics were applied for 67% (10/15) of the ESBL strains within 2 weeks before the onset of LOS. The rate of antibiotic use for ESBL strains was significantly higher than that for non-resistant strains [67% (10/15) vs 29% (7/24); P<0.05]. CONCLUSIONS Low birth weight, SGA infant, and long indwelling time of PICC are independent risk factors for LOS in VLBW/ELBW infants, and death tends to occur in LOS infants with purulent meningitis. Most pathogenic bacteria of LOS are Gram-negative bacteria, and use of antibiotics within 2 weeks before disease onset may increase the risk of ESBL strain infection.
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Affiliation(s)
- Hui-Qiang Liu
- Department of Neonatology, Peking University Third Hospital, Beijing 100191, China.
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