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Molad M, Gover A, Marai Z, Lavie-Nevo K, Kessel I, Shemer-Meiri L, Soloveichik M. Neurodevelopmental Outcome of Very Low Birth Weight Infants in the Northern District of Israel: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1320. [PMID: 37628319 PMCID: PMC10453082 DOI: 10.3390/children10081320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Currently, no local database in Israel collects neurodevelopmental outcomes of very low birth weight (VLBW) preterm infants. We investigated neurodevelopmental outcomes in one district of the largest healthcare organization in Israel. METHODS A cross-sectional study including all VLBW (<1500 g) preterm infants born between 1 January 2006 and 31 December 2016 who were followed in any of seven child development centers in Israel's Northern District. Data were retrospectively collected from the computerized medical record database. RESULTS Out of 436 participants, 55.1% had normal developmental outcomes. A total of 8.9% had cerebral palsy (CP), 12.2% had a global developmental delay (GDD), and 33.4% had a language delay. Out of the extremely preterm infants (n = 109), 20.2% had CP, 22.0% had GDD, and 44.9% had language delay. We found a statistically significant higher rate of abnormal neurodevelopment outcomes in non-Jews compared to Jews (57% vs. 37.8%, respectively, p < 0.0001). CONCLUSIONS We found a relatively high overall rate of CP in our local population and a significant difference in neurodevelopmental outcomes between Jews and non-Jews. This study emphasizes the need for an expanded and detailed national database collecting post-discharge outcomes, as well as an assessment of national healthcare resource allocation and inequalities in preterm infants' post-discharge care.
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Affiliation(s)
- Michal Molad
- Neonatal Intensive Care Unit, Carmel Medical Center, Haifa 3436212, Israel; (M.M.); (K.L.-N.); (I.K.); (M.S.)
- Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3525433, Israel;
| | - Ayala Gover
- Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3525433, Israel;
- Neonatal Intensive Care Unit, Bnai Zion Medical Center, Haifa 31048, Israel
| | - Zaki Marai
- Pediatrics Department, Carmel Medical Center, Haifa, 3436212, Israel;
| | - Karen Lavie-Nevo
- Neonatal Intensive Care Unit, Carmel Medical Center, Haifa 3436212, Israel; (M.M.); (K.L.-N.); (I.K.); (M.S.)
- Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3525433, Israel;
| | - Irina Kessel
- Neonatal Intensive Care Unit, Carmel Medical Center, Haifa 3436212, Israel; (M.M.); (K.L.-N.); (I.K.); (M.S.)
- Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3525433, Israel;
| | - Lilach Shemer-Meiri
- Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3525433, Israel;
- Pediatrics Department, Carmel Medical Center, Haifa, 3436212, Israel;
| | - Marina Soloveichik
- Neonatal Intensive Care Unit, Carmel Medical Center, Haifa 3436212, Israel; (M.M.); (K.L.-N.); (I.K.); (M.S.)
- Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3525433, Israel;
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van Noort-van der Spek IL, Dudink J, Reiss IK, Franken MCJP. Early Speech Sound Production and Its Trajectories in Very Preterm Children From 2 to 4 Years of Age. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1294-1310. [PMID: 35263167 DOI: 10.1044/2021_jslhr-21-00388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Very preterm (VPT) children are at risk for speech and language problems throughout school age. However, little is known about early speech sound production in these children. This study aims to present a detailed description of early speech sound production and its trajectories in VPT children from 2 to 4 years of age. In addition, this study aimed to determine if early speech sound production is associated with speech production and expressive language function at 4 years of age. METHOD In 63 VPT children (< 32 weeks of gestation, 41 boys, mean gestational age = 28.8 weeks, mean birth weight = 1,135 g), speech sound production was assessed by naturalistic speech analysis at 2 years of corrected age and speech and language function by standardized tests at 4 years of age. RESULTS Speech sound production was found to be abnormal in 49% of the VPT children at 2 years of age and in 19% at 4 years of age. Four different speech production trajectories from 2 to 4 years of age could be identified: a normal trajectory, an abnormal trajectory, a catch-up trajectory, and a growing-into-deficit trajectory. Early speech production, defined by the number of acquired consonants at 2 years of age, significantly predicted the word production score at 4 years of age and the sentence production score at 4 years of age. CONCLUSIONS Compared to the general population, an alarmingly high proportion of VPT children showed speech production problems at 2 years of age. About half of these children showed persistent speech problems at 4 years of age. Moreover, these problems were associated with expressive language problems at the age of 4 years. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19310822.
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Affiliation(s)
- Inge L van Noort-van der Spek
- Department of Otorhinolaryngology, Sophia Children's Hospital, Erasmus Medical University Center, Rotterdam, the Netherlands
| | - Jeroen Dudink
- Division of Neonatology, Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical University Center, Rotterdam, the Netherlands
- Division of Neonatology, Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Centre, Utrecht, the Netherlands
| | - Irwin K Reiss
- Division of Neonatology, Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical University Center, Rotterdam, the Netherlands
| | - Marie-Christine J P Franken
- Department of Otorhinolaryngology, Sophia Children's Hospital, Erasmus Medical University Center, Rotterdam, the Netherlands
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van Noort-van der Spek IL, Stipdonk LW, Goedegebure A, Dudink J, Willemsen S, Reiss IKM, Franken MCJP. Are multidisciplinary neurodevelopmental profiles of children born very preterm at age 2 relevant to their long-term development? A preliminary study. Child Neuropsychol 2021; 28:437-457. [PMID: 34727843 DOI: 10.1080/09297049.2021.1991296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
To identify distinctive multidisciplinary neurodevelopmental profiles of relatively healthy children born very preterm (VPT) and describe the longitudinal course of these profiles up to age 10. At 2 years of corrected age, 84 children born VPT underwent standardized testing for cognitive, language, speech, motor, behavioral, and auditory nerve function. These data were submitted to factor and cluster analysis. Sixty-one of these children underwent cognitive, language, and behavioral assessment again at age 10. Descriptive statistics were used to analyze longitudinal trajectories for each profile. Four neurodevelopmental profiles were identified at age 2. Profile 1 children (n = 22/26%) had excellent cognitive-language-motor function, normal behavioral and auditory nerve function, but showed an unexpected severe decline up to age 10. Profile 2 children (n = 16/19%) had very low behavioral function, low cognitive-language-motor function, and accelerated auditory nerve function. Their scores remained low up until age 10. Profile 3 children (n = 17/20%) had delayed auditory nerve function, low behavioral function, and slightly lower cognitive-language-motor function. They showed the most increasing trajectory. Profile 4 children (n = 29/35%) had very low cognitive-language-motor function, normal behavioral and auditory nerve function, but showed wide variation in their trajectory. Our preliminary study showed that a multidisciplinary profile-oriented approach may be important in children born VPT to improve counseling and provide targeted treatment for at risk children. High performers at age 2 may not be expected to maintain their favorable development. Behavioral problems might negatively impact language development. Delayed auditory nerve function might represent a slow start and catch-up development.
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Affiliation(s)
- Inge L van Noort-van der Spek
- Department of Otorhinolaryngology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Lottie W Stipdonk
- Department of Otorhinolaryngology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Jeroen Dudink
- Division of Neonatology, Department of Pediatrics, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands.,Division of Neonatology, Department of Pediatrics, UMCU-Wilhelmina Children's Hospital, Utrecht, Netherlands
| | - Sten Willemsen
- Department of Biostatistics, Erasmus Medical University Center, Rotterdam, Netherlands
| | - Irwin K M Reiss
- Division of Neonatology, Department of Pediatrics, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Marie-Christine J P Franken
- Department of Otorhinolaryngology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
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Functional Hyperconnectivity during a Stories Listening Task in Magnetoencephalography Is Associated with Language Gains for Children Born Extremely Preterm. Brain Sci 2021; 11:brainsci11101271. [PMID: 34679336 PMCID: PMC8534020 DOI: 10.3390/brainsci11101271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 01/25/2023] Open
Abstract
Extreme prematurity (EPT, <28 weeks gestation) is associated with language problems. We previously reported hyperconnectivity in EPT children versus term children (TC) using magnetoencephalography (MEG). Here, we aim to ascertain whether functional hyperconnectivity is a marker of language resiliency for EPT children, validating our earlier work with a distinct sample of contemporary well-performing EPT and preterm children with history of language delay (EPT-HLD). A total of 58 children (17 EPT, 9 EPT-HLD, and 32 TC) participated in stories listening during MEG and functional magnetic resonance imaging (fMRI) at 4–6 years. We compared connectivity in EPT and EPT-HLD, investigating relationships with language over time. We measured fMRI activation during stories listening and parcellated the activation map to obtain “nodes” for MEG connectivity analysis. There were no significant group differences in age, sex, race, ethnicity, parental education, income, language scores, or language representation on fMRI. MEG functional connectivity (weighted phase lag index) was significantly different between groups. Preterm children had increased connectivity, replicating our earlier work. EPT and EPT-HLD had hyperconnectivity versus TC at 24–26 Hz, with EPT-HLD exhibiting greatest connectivity. Network strength correlated with change in standardized scores from 2 years to 4–6 years of age, suggesting hyperconnectivity is a marker of advancing language development.
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van Noort-van der Spek IL, Franken MCJP, Swarte RMC, Weisglas-Kuperus N. Validity of an early parent-report questionnaire for language disorder in very preterm children from 2 to 10 years of age. Eur J Paediatr Neurol 2021; 34:1-6. [PMID: 34245929 DOI: 10.1016/j.ejpn.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/24/2021] [Accepted: 06/14/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Language problems at an early age in very preterm (VP) children can have a detrimental effect on other developmental domains and often persist throughout childhood. The aim of this study was to examine the concurrent and predictive validity of an early language parent-report questionnaire for language disorder in VP children from 2 to 10 years of age. MATERIALS AND METHODS In 80 VP children (<32 weeks' gestation) without major disabilities, a parent-questionnaire and formal language assessment, both normed for the general population, were administered at 2 years corrected age (CA). Of these infants, 62 were seen for follow-up formal language assessment at age 4 and 61 were seen at age 10. Sensitivity and specificity values were calculated. RESULTS The Lexi-list showed acceptable concurrent validity for word production scores obtained at age 2 CA. The predictive validity was good for sentence production and acceptable for word production scores obtained at age 4, and low for language production scores obtained at age 10. A Lexi-list cut-off score of <85 (i.e., <-1 SD) was found optimal. INTERPRETATION A norm-referenced parent-report questionnaire is a useful, first screening tool in a neonatal follow-up. It not only detected early language disorder at age 2 CA but also proved to be a good predictor for language disorder at age 4. However, it did not predict language disorder at age 10. Formal language assessment at age 4 would therefore be recommended for children with an abnormal parent-report language score at age 2 CA.
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Affiliation(s)
- Inge L van Noort-van der Spek
- Department of Otorhinolaryngology at Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands.
| | - Marie-Christine J P Franken
- Department of Otorhinolaryngology at Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Renate M C Swarte
- Division of Neonatology, Department of Pediatrics at Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Nynke Weisglas-Kuperus
- Division of Neonatology, Department of Pediatrics at Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
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Mahurin-Smith J, DeThorne LS, Petrill SA. Children Born Prematurely May Demonstrate Catch-Up Growth in Pre-Adolescence. Lang Speech Hear Serv Sch 2021; 52:675-685. [PMID: 33656921 DOI: 10.1044/2020_lshss-20-00111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction Children born prematurely often score lower on standardized tests of language in early childhood. Less is known about longer term outcomes. This investigation considered language outcomes in pre-adolescent children born very preterm/very low birthweight, as assessed by both standardized test scores and language sample measures, and explored attention abilities as a possible moderating factor. Method The present investigation provided a longitudinal follow-up to Mahurin Smith et al. (2014) by examining the language outcomes of 84 children at the 11-year time point (39 with a history of prematurity and 45 born at full term) and a total of 82 at the 12-year time point (37 with a history of prematurity, 45 born at full term). Assessments included subtests of the Clinical Evaluation of Language Fundamentals- Fourth Edition, productive language measures taken from narrative tasks, and parent and examiner ratings of attention. Results Gestational age significantly predicted standardized language scores at age 11 years, but this effect was no longer statistically significant at age 12 years. When parent ratings of attention were considered as additional variables, gestational age was no longer a significant predictor. Gestational age did not serve as a significant predictor for the productive language measures at either time point. Discussion Results indicate that catch-up growth in language may take place in pre-adolescence for many children born prematurely. Clinical implications focus on the need to utilize multiple forms of language assessment and to directly consider the potential role of attention on standard test results.
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Affiliation(s)
- Jamie Mahurin-Smith
- Department of Communication Sciences and Disorders, Illinois State University, Normal
| | - Laura S DeThorne
- Department of Speech, Language, and Hearing Sciences, Western Michigan University, Kalamazoo
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