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Thalhammer M, Nimpal M, Schulz J, Meedt V, Menegaux A, Schmitz-Koep B, Daamen M, Boecker H, Zimmer C, Priller J, Wolke D, Bartmann P, Hedderich D, Sorg C. Consistently lower volumes across thalamus nuclei in very premature-born adults. Neuroimage 2024; 297:120732. [PMID: 39004408 DOI: 10.1016/j.neuroimage.2024.120732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/08/2024] [Accepted: 07/11/2024] [Indexed: 07/16/2024] Open
Abstract
Lasting thalamus volume reduction after preterm birth is a prominent finding. However, whether thalamic nuclei volumes are affected differentially by preterm birth and whether nuclei aberrations are relevant for cognitive functioning remains unknown. Using T1-weighted MR-images of 83 adults born very preterm (≤ 32 weeks' gestation; VP) and/or with very low body weight (≤ 1,500 g; VLBW) as well as of 92 full-term born (≥ 37 weeks' gestation) controls, we compared thalamic nuclei volumes of six subregions (anterior, lateral, ventral, intralaminar, medial, and pulvinar) across groups at the age of 26 years. To characterize the functional relevance of volume aberrations, cognitive performance was assessed by full-scale intelligence quotient using the Wechsler Adult Intelligence Scale and linked to volume reductions using multiple linear regression analyses. Thalamic volumes were significantly lower across all examined nuclei in VP/VLBW adults compared to controls, suggesting an overall rather than focal impairment. Lower nuclei volumes were linked to higher intensity of neonatal treatment, indicating vulnerability to stress exposure after birth. Furthermore, we found that single results for lateral, medial, and pulvinar nuclei volumes were associated with full-scale intelligence quotient in preterm adults, albeit not surviving correction for multiple hypotheses testing. These findings provide evidence that lower thalamic volume in preterm adults is observable across all subregions rather than focused on single nuclei. Data suggest the same mechanisms of aberrant thalamus development across all nuclei after premature birth.
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Affiliation(s)
- Melissa Thalhammer
- Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, School of Medicine and Health, Munich, Germany; Technical University of Munich, School of Medicine and Health, TUM-NIC Neuroimaging Center, Munich, Germany.
| | - Mehul Nimpal
- Faculty of Biology, Graduate School of Systemic Neurosciences, Ludwig Maximilian University of Munich
| | - Julia Schulz
- Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, School of Medicine and Health, Munich, Germany; Technical University of Munich, School of Medicine and Health, TUM-NIC Neuroimaging Center, Munich, Germany
| | - Veronica Meedt
- Faculty of Biology, Ludwig Maximilian University of Munich
| | - Aurore Menegaux
- Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, School of Medicine and Health, Munich, Germany; Technical University of Munich, School of Medicine and Health, TUM-NIC Neuroimaging Center, Munich, Germany
| | - Benita Schmitz-Koep
- Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, School of Medicine and Health, Munich, Germany; Technical University of Munich, School of Medicine and Health, TUM-NIC Neuroimaging Center, Munich, Germany
| | - Marcel Daamen
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Clinical Functional Imaging Group, Bonn, Germany; Department of Neonatology and Pediatric Intensive Care, University Hospital Bonn, Bonn, Germany
| | - Henning Boecker
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Clinical Functional Imaging Group, Bonn, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, School of Medicine and Health, Munich, Germany; Technical University of Munich, School of Medicine and Health, TUM-NIC Neuroimaging Center, Munich, Germany
| | - Josef Priller
- Department of Psychiatry, Technical University of Munich, School of Medicine and Health, Munich, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - Peter Bartmann
- Department of Neonatology and Pediatric Intensive Care, University Hospital Bonn, Bonn, Germany
| | - Dennis Hedderich
- Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, School of Medicine and Health, Munich, Germany; Technical University of Munich, School of Medicine and Health, TUM-NIC Neuroimaging Center, Munich, Germany
| | - Christian Sorg
- Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, School of Medicine and Health, Munich, Germany; Technical University of Munich, School of Medicine and Health, TUM-NIC Neuroimaging Center, Munich, Germany; Department of Psychiatry, Technical University of Munich, School of Medicine and Health, Munich, Germany
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2
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Eves R, Wolke D, Spiegler J, Lemola S. Association of Birth Weight Centiles and Gestational Age With Cognitive Performance at Age 5 Years. JAMA Netw Open 2023; 6:e2331815. [PMID: 37651137 PMCID: PMC10472194 DOI: 10.1001/jamanetworkopen.2023.31815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/26/2023] [Indexed: 09/01/2023] Open
Abstract
Importance Birth weight percentiles (BWPs) are often dichotomized at the 10th percentile and show statistically significant association with later cognitive performance, for both preterm and term-born children. However, research testing nonlinear associations between BWPs and cognitive performance is scarce. Objective To investigate culturally invariant, nonlinear associations of BWPs and gestational age with later cognitive performance. Design, Setting, and Participants In this cohort study, participants with valid neonatal and cognitive data were combined from 4 observational cohorts, including the Millennium Cohort Study, the National Longitudinal Survey of Youth 1979 Child and Young Adult cohort, Growing Up in Ireland, and the Longitudinal Study of Australian Children, with children born between 2000 and 2002, 1980 and 2010, 2007 and 2008, and 2003 and 2004, respectively. Neonatal data were parent reported before age 1 year. At approximately 5 years of age, multiple cognitive tests were performed. Follow-up at 5 years of age was the predominant focus. Data were analyzed July 17, 2023. Exposure The parent-reported neonatal data were used to calculate BWPs according to the Fenton growth chart. Main Outcome and Measure Scores for IQ were created from multiple measures of cognition, which were z standardized separately within each cohort. Results Of 30 643 participants (50.8% male), 7.5% were born preterm (before 37 weeks gestation) and 92.5% were term born (between 37 and 42 weeks gestation). In the pooled data using multivariate adaptive regression splines, IQ linearly increased by 4.2 points as BWPs increased from the first to the 69th percentile before completely plateauing. For gestational age, IQ linearly increased by 1.3 points per week up until 32 weeks, with the association reducing to 0.3 points per week after 32 weeks. The association of BWP with IQ was not moderated by gestational age. For term-born infants, the estimated IQ score was only clinically meaningfully lower than average when birth weight was below the third percentile. Consistent results were found when instead using multivariable regression where gestational age and BWPs were categorized into groups. Conclusions and Relevance In this cohort study, lower BWPs and gestational age were independently associated with lower IQ. For term-born infants, a cutoff of the third percentile would be more appropriate than the traditionally used 10th percentile when the aim is estimating meaningful cognitive differences.
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Affiliation(s)
- Robert Eves
- Fakultät für Psychologie und Sportwissenschaft, Universität Bielefeld, Bielefeld, Germany
- Department of Psychology, Lifespan Health and Wellbeing Group, University of Warwick, Warwick, England, United Kingdom
| | - Dieter Wolke
- Department of Psychology, Lifespan Health and Wellbeing Group, University of Warwick, Warwick, England, United Kingdom
| | - Juliane Spiegler
- Kinderklinik, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Sakari Lemola
- Fakultät für Psychologie und Sportwissenschaft, Universität Bielefeld, Bielefeld, Germany
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3
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Scheeren MFDC, Fiori HH, Machado LU, Volkmer DDFV, Oliveira MGD. Exact Gestational Age, Term Versus Early Term, Is Associated with Different Breastfeeding Success Rates in Mothers Delivered by Elective Cesarean Section. Breastfeed Med 2022; 17:825-831. [PMID: 36103275 DOI: 10.1089/bfm.2022.0068] [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] [Indexed: 11/12/2022]
Abstract
Objectives: The study was intended to verify the association between the gestational age of newborns classified as term and the success of breastfeeding in babies born by elective cesarean section. Also, to analyze how the variability of gestational age within the term influences breastfeeding. Materials and Methods: Retrospective study of a cohort, which included full-term newborns and their mothers, whose deliveries occurred by elective cesarean section. Among the inclusion criteria are delivery due to elective cesarean section and minimum gestational age of 37 weeks. The database consisted of medical birth information and interviews with mothers. Results: This study included 954 full-term newborns born by elective cesarean section. Exclusive breastfeeding at 3 months and being breastfed at 6 months showed a statistically significant association in the correlation with the variability of gestational age. There was a statistically significant association between exclusive breastfeeding at 3 months and breastfeeding at 6 months in the correlation between early term and full term. The trend test showed a significant progressive in the breastfeeding curve versus gestational age. Conclusion: Full-term newborns show better results of exclusive breastfeeding at 3 months and continued breastfeeding at 6 months, compared with those born at early term. Gestational age, even in term, has an influence on the success of breastfeeding in newborns undergoing elective cesarean delivery.
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Affiliation(s)
- Marôla Flores da Cunha Scheeren
- Moinhos de Vento Hospital, Porto Alegre, Brazil.,Department of Pediatrics and Children's Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Humberto Holmer Fiori
- Department of Pediatrics and Children's Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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Emrani SE, Groene SG, Verweij EJ, Slaghekke F, Khalil A, Klink JMMV, Tiblad E, Lewi L, Lopriore E. Gestational Age at Birth and outcome in Monochorionic Twins with Different Types of Selective Fetal Growth Restriction: A Systematic Literature Review. Prenat Diagn 2022; 42:1094-1110. [PMID: 35808908 PMCID: PMC9543733 DOI: 10.1002/pd.6206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/15/2022] [Accepted: 07/03/2022] [Indexed: 11/09/2022]
Abstract
This systematic review aims to assess the gestational age at birth and perinatal outcome (intrauterine demise (IUD), neonatal mortality and severe cerebral injury) in monochorionic (MC) twins with selective fetal growth restriction (sFGR), according to Gratacós classification based on umbilical artery Doppler flow patterns in the smaller twin. Seventeen articles were included. Gestational age at birth varied from 33.0-36.0 weeks in type I, 27.6-32.4 weeks in type II, and 28.3-33.8 weeks in type III. IUD rate differed from 0-4% in type I to 0-40% in type II and 0-23% in type III. Neonatal mortality rate was between 0-10% in type I, 0-38% in type II, and 0-17% in type III. Cerebral injury was present in 0-2% of type I, 2-30% of type II and 0-33% of type III cases. The timing of delivery in sFGR varied substantially among studies, particularly in type II and III. The quality of evidence was moderate due to heterogenous study populations with varying definitions of sFGR and perinatal outcome parameters, as well as a lack of consensus on the use of the Gratacós classification, leading to substantial incomparability. Our review identifies the urgent need for uniform antenatal diagnostic criteria and definitions of outcome parameters. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Salma El Emrani
- Neonatology, Willem-Alexander Children's Hospital, Dept. of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Sophie G Groene
- Neonatology, Willem-Alexander Children's Hospital, Dept. of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - E Joanne Verweij
- Fetal Medicine, Dept. of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Femke Slaghekke
- Fetal Medicine, Dept. of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Asma Khalil
- Fetal Medicine Unit, Dept. of Obstetrics, St George's Hospital, University of London, London, UK, Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of, UK; and Fetal Medicine Unit, Liverpool Women's Hospital, University of Liverpool, London, UK
| | - Jeanine M M van Klink
- Neonatology, Willem-Alexander Children's Hospital, Dept. of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Eleonor Tiblad
- Center for Fetal Medicine, Pregnancy Care and Delivery, Women´s Health, Karolinska University Hospital, and Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Liesbeth Lewi
- Fetal Medicine, Dept. of Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Enrico Lopriore
- Neonatology, Willem-Alexander Children's Hospital, Dept. of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
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5
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Jaekel J, Anderson PJ, Bartmann P, Cheong JLY, Doyle LW, Hack M, Johnson S, Marlow N, Saigal S, Schmidt L, Sullivan MC, Wolke D. Mathematical performance in childhood and early adult outcomes after very preterm birth: an individual participant data meta-analysis. Dev Med Child Neurol 2022; 64:421-428. [PMID: 34913160 DOI: 10.1111/dmcn.15132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 11/30/2022]
Abstract
AIM To investigate the strength of the independent associations of mathematics performance in children born very preterm (<32wks' gestation or <1500g birthweight) with attending postsecondary education and their current employment status in young adulthood. METHOD We harmonized data from six very preterm birth cohorts from five different countries and carried out one-stage individual participant data meta-analyses (n=954, 52% female) using mixed effects logistic regression models. Mathematics scores at 8 to 11 years of age were z-standardized using contemporary cohort-specific controls. Outcomes included any postsecondary education, and employment/education status in young adulthood. All models were adjusted for year of birth, gestational age, sex, maternal education, and IQ in childhood. RESULTS Higher mathematics performance in childhood was independently associated with having attended any postsecondary education (odds ratio [OR] per SD increase in mathematics z-score: 1.36 [95% confidence interval {CI}: 1.03, 1.79]) but not with current employment/education status (OR 1.14 per SD increase [95% CI: 0.87, 1.48]). INTERPRETATION Among populations born very preterm, childhood mathematics performance is important for adult educational attainment, but not for employment status.
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Affiliation(s)
- Julia Jaekel
- Psychology, University of Oulu, Oulu, Finland.,Psychology, University of Warwick, Coventry, UK.,Child and Family Studies/Psychology, University of Tennessee Knoxville, Knoxville, TN, USA.,Department of Health Sciences, University of Leicester, Leicester, UK
| | - Peter J Anderson
- Turner Institute for Brain & Mental Health, School of Psychology Sciences, Monash University, Melbourne, VIC, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Peter Bartmann
- Children's Hospital, University Hospital Bonn, Bonn, Germany
| | - Jeanie L Y Cheong
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia.,Neonatal Services, Royal Women's Hospital, Melbourne, VIC, Australia
| | - Lex W Doyle
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia.,Neonatal Services, Royal Women's Hospital, Melbourne, VIC, Australia
| | - Maureen Hack
- Neonatology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Neil Marlow
- EGA Institute for Women's Health, University College London, London, UK
| | - Saroj Saigal
- Pediatrics, McMaster University, Hamilton, ON, USA
| | - Louis Schmidt
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Mary C Sullivan
- College of Nursing, University of Rhode Island, Providence, RI, USA
| | - Dieter Wolke
- Psychology, University of Warwick, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK
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Verhage CH, Groenendaal F, van der Net J, van Schooneveld MM, de Vries LS, van der Aa NE. Bimanual performance in children with unilateral perinatal arterial ischaemic stroke or periventricular haemorrhagic infarction. Eur J Paediatr Neurol 2022; 37:46-52. [PMID: 35093802 DOI: 10.1016/j.ejpn.2022.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/13/2021] [Accepted: 01/11/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Long term outcome data on bimanual performance in children with perinatal arterial ischaemic stroke (PAIS) and periventricular haemorrhagic infarction (PVHI) with and without unilateral spastic cerebral palsy (USCP) is sparse. AIMS To assess bimanual performance in children with PAIS or PVHI with and without USCP and to explore the relationship with unilateral hand function and full-scale IQ (FSIQ) in a cross-sectional study. METHODS Fifty-two children with PAIS (n = 27) or PVHI (n = 25) participated at a median age of 12 years and 1 month (range 6-20 years). The Bruininks Oseretsky Test of Motor Proficiency-2 (bimanual precision and dexterity subtest), Assisting Hand Assessment, Purdue Pegboard Test and Wechsler Intelligence scale were administered. RESULTS Bimanual dexterity was worse in children with USCP (p < 0.02) without a difference for the pathology groups. In children without USCP (n = 21), those with PAIS showed a better bimanual precision compared to children with PVHI (p < 0.04). The AHA score and the Purdue Pegboard score of the dominant hand explained 51% of the variance in bimanual precision and dexterity in children with USCP. In absence of USCP, FSIQ together with AHA scores explained 66% of the variance in bimanual precision and FSIQ together with the Purdue Pegboard Test score of the dominant hand, 71% of the variance in bimanual dexterity. CONCLUSIONS Children with PAIS without USCP have a more favourable bimanual hand function compared to children with PVHI. This difference appears to be associated with a preserved FSIQ.
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Affiliation(s)
- Cornelia H Verhage
- Center for Child Development, Exercise and Physical Literacy, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| | - Floris Groenendaal
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Janjaap van der Net
- Center for Child Development, Exercise and Physical Literacy, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Monique Mj van Schooneveld
- Sector of Neuropsychology, Department of Pediatric Psychology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Linda S de Vries
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Niek E van der Aa
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
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7
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Halme H, McMullen J, Nanu CE, Nyman A, Hannula-Sormunen MM. Mathematical skills of 11-year-old children born very preterm and full-term. J Exp Child Psychol 2022; 219:105390. [PMID: 35219122 DOI: 10.1016/j.jecp.2022.105390] [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: 12/15/2020] [Revised: 11/18/2021] [Accepted: 01/23/2022] [Indexed: 10/19/2022]
Abstract
Preterm birth affects the academic development of children, especially in mathematics. Remarkably, only a few studies have measured specific effects of preterm birth on mathematical skills in primary school. The aim of this study was to compare 11-year-old children, with an IQ above 70, born very preterm (N = 64) and full-term (N = 72) on a variety of 5th grade mathematical skills and cognitive abilities important for mathematical learning. The measures were spontaneous focusing on numerosity (SFON), spontaneous focusing on quantitative relations (SFOR), arithmetic fluency, mathematics achievement, number line estimation, rational number magnitude knowledge, mathematics motivation, reading skills, visuospatial processing, executive functions, and naming speed. The children born very preterm and full-term differed in arithmetic fluency, SFON and SFOR. Domain general cognitive abilities did not fully explain the group differences in SFON and SFOR. Retrospective comparisons of the samples at the age of five years showed large group differences in early mathematical skills and cognitive abilities. Despite lower early mathematical skills, the children born very preterm reached peer equivalent performance in many mathematical skills by the age of 11 years. Nevertheless, they appear less likely to focus on implicit mathematical features in their everyday life.
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Affiliation(s)
- Hilma Halme
- Department of Teacher Education, 20014 University of Turku, Finland.
| | - Jake McMullen
- Department of Teacher Education, 20014 University of Turku, Finland.
| | - Cristina E Nanu
- Department of Teacher Education, 20014 University of Turku, Finland.
| | - Anna Nyman
- Department of Psychology, 20014 University of Turku, Finland
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- Turku University Hospital, 20521 Turku, Finland
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Héon M, Aita M, Lavallée A, De Clifford-Faugère G, Laporte G, Boisvert A, Feeley N. Comprehensive mapping of NICU developmental care nursing interventions and related sensitive outcome indicators: a scoping review protocol. BMJ Open 2022; 12:e046807. [PMID: 35105609 PMCID: PMC8808373 DOI: 10.1136/bmjopen-2020-046807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Neurodevelopmental outcomes of preterm infant are still a contemporary concern. To counter the detrimental effects resulting from the hospitalisation in the neonatal intensive care unit (NICU), developmental care (DC) interventions have emerged as a philosophy of care aimed at protecting and enhancing preterm infant's development and promoting parental outcomes. In the past two decades, many authors have suggested DC models, core measures, practice guidelines and standards of care but outlined different groupings of interventions rather than specific interventions that can be used in NICU clinical practice. Moreover, as these DC interventions are mostly implemented by neonatal nurses, it would be strategic and valuable to identify specific outcome indicators to make visible the contribution of NICU nurses to DC. OBJECTIVES The overarching objective of this review is to identify the nature, range, and extent of the literature regarding DC nursing interventions for preterm infants in the NICU. The secondary twofold objectives are to highlight interventions that fall into identified categories of DC interventions and suggest nursing-sensitive outcome indicators related to DC interventions in the NICU. INCLUSION CRITERIA Papers reporting on or discussing a DC nursing intervention during NICU hospitalisation will be included. METHODS AND ANALYSIS The Joanna Briggs Institute's methodology for scoping reviews will be followed. CINAHL, MEDLINE, Embase, PubMed, Web of Science, Scopus, ProQuest and PsycInfo databases from 2009 to the present will be searched. Any type of paper, published in English or French, will be considered. Study selection and data extraction will be conducted by pairs of two review authors independently. A qualitative content analysis will be conducted. ETHICS AND DISSEMINATION No Institutional Review Board ethical approbation is needed. Results of this review will be presented in scientific meetings and published in refereed papers.
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Affiliation(s)
- Marjolaine Héon
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Quebec Network on Nursing Intervention Research/Réseau de Recherche en Interventions en Sciences Infirmières du Québec (RRISIQ), Montreal, Quebec, Canada
| | - Marilyn Aita
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Quebec Network on Nursing Intervention Research/Réseau de Recherche en Interventions en Sciences Infirmières du Québec (RRISIQ), Montreal, Quebec, Canada
- Research Centre, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Andréane Lavallée
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Research Centre, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Gwenaëlle De Clifford-Faugère
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Research Centre, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Geneviève Laporte
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Research Centre, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Annie Boisvert
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- NICU, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Nancy Feeley
- Quebec Network on Nursing Intervention Research/Réseau de Recherche en Interventions en Sciences Infirmières du Québec (RRISIQ), Montreal, Quebec, Canada
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
- Centre for Nursing Research and Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
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9
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Predictive value of brain MRI at term-equivalent age in extremely preterm children on neurodevelopmental outcome at school-age. Brain Imaging Behav 2021; 16:878-887. [PMID: 34661873 DOI: 10.1007/s11682-021-00559-9] [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] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
This study's objective was to correlate the abnormalities in brain MRIs performed at corrected-term age for minor or moderate neurocognitive disorders in children school-age born extremely premature (EPT) and without serious sequelae such as autism, cerebral palsy, mental impairment. Data were issued from a cross-sectional multicenter study (GP-Qol study, number NCT01675726). Clinical examination and psychometric assessments were performed when the children were between 7 and 10 years old during a day-long evaluation. Term-equivalent age brain MRIs on EPT were analyzed with a standardized scoring system. There were 114 children included in the study. The mean age at the time of evaluation, was 8.47 years old (± 0.70). 59% of children with at least one cognitive impairment and 53% who had a dysexecutive disorder. Only ten EPT (8.7%) presented moderate to severe white and grey matter abnormalities. These moderate to severe grey matter abnormalities were associated with at least two abnormal executive functions [OR 3.08 (95% CI 1.04-8.79), p = 0.04] and language delay [OR 3.25 (95% CI 1.03-9.80), p = 0.04]. These results remained significant in the multivariate analysis. Moderate to severe ventricular dilatation abnormalities (15%, n = 17) were associated with ideomotor dyspraxia [OR 7.49 (95% CI 1.48-35.95), p = 0.02] and remained significant in multivariate analysis [OR 11.2 (95% CI 1.45-131.4), p = 0.02]. Biparietal corrected diameters were moderate abnormal in 20% of cases (n = 23) and were associated to visuo spatial integration delay [OR 4.13 (95% CI 1.23-13.63), p = 0.02]. Cerebral MRI at term-equivalent age with scoring system analysis can provide information on long-term neuropsychological outcomes at school-age in EPTs children having no severe disability.
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Heuser-Spura KM, Jaekel J, Wolke D. The Impact of Formal School Entry on Children's Social Relationships with Parents, Siblings, and Friends. CHILDREN (BASEL, SWITZERLAND) 2021; 8:891. [PMID: 34682156 PMCID: PMC8535132 DOI: 10.3390/children8100891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/24/2021] [Accepted: 10/02/2021] [Indexed: 11/17/2022]
Abstract
The normative transition to formal schooling confronts children with social challenges but also opportunities. Longitudinal research on how school entry impacts children's family and friend-ship relationships is scarce. This study investigated social relationship qualities with parents, siblings, and friends among 1110 children (49.9% female) from the prospective, population-based Bavarian Longitudinal Study at 6 years (before school entry) and 8 years using a forced-choice card-sorting task. Multivariate analyses of variance revealed significant effects of age (i.e., school entry) on social relationship qualities with mothers (Pillai's Trace (PT) = 0.28, F(9, 1101) = 47.73, p < 0.001), fathers (PT = 0.14, F(9, 1101) = 19.47, p < 0.001), siblings (PT = 0.27, F(9, 1101) = 46.14, p < 0.001), and friends (PT = 0.21, F(9, 1101) = 32.57, p < 0.001). On average, children reported higher levels of parental comfort after school entry. Companionable qualities increased in relationships with friends, whereas sibling relationships became more conflictual from preschool to early school age. Findings provide unique insights into how social relationships develop from preschool to early school age, supporting evidence of the growing importance of friends. Conflict was predominant and increasing in sibling relationships and should be considered more in future research.
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Affiliation(s)
- Katharina M. Heuser-Spura
- Department of Pediatrics I, Neonatology, Pediatric Intensive Care and Pediatric Neurology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany
- Faculty of Psychology, Ruhr-University Bochum, 44801 Bochum, Germany
| | - Julia Jaekel
- Unit of Psychology, Faculty of Education, University of Oulu, 90570 Oulu, Finland;
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK;
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK;
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
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11
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Eves R, Mendonça M, Baumann N, Ni Y, Darlow BA, Horwood J, Woodward LJ, Doyle LW, Cheong J, Anderson PJ, Bartmann P, Marlow N, Johnson S, Kajantie E, Hovi P, Nosarti C, Indredavik MS, Evensen KAI, Räikkönen K, Heinonen K, Zeitlin J, Wolke D. Association of Very Preterm Birth or Very Low Birth Weight With Intelligence in Adulthood: An Individual Participant Data Meta-analysis. JAMA Pediatr 2021; 175:e211058. [PMID: 34047752 PMCID: PMC8329745 DOI: 10.1001/jamapediatrics.2021.1058] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Birth before 32 weeks' gestation (very preterm [VPT]) and birth weight below 1500 g (very low birth weight [VLBW]) have been associated with lower cognitive performance in childhood. However, there are few investigations of the association of neonatal morbidities and maternal educational levels with the adult cognitive performance of individuals born VPT or VLBW (VPT/VLBW). OBJECTIVE To assess differences in adult IQ between VPT/VLBW and term-born individuals and to examine the association of adult IQ with cohort factors, neonatal morbidities, and maternal educational level among VPT/VLBW participants. DATA SOURCES Systematic review of published data from PubMed and meta-analysis of individual participant data (IPD) of cohorts from 2 consortia (Research on European Children and Adults Born Preterm [RECAP] and Adults Born Preterm International Collaboration [APIC]). STUDY SELECTION The meta-analysis included prospective longitudinal cohort studies that assessed the full-scale IQ of adults born VPT or VLBW and respective control groups comprising term-born adults. DATA EXTRACTION AND SYNTHESIS The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline for analyses of individual participant data and identified 8 studies that provided data from 2135 adults (1068 VPT/VLBW and 1067 term-born participants) born between 1978 and 1995. Meta-analyses of IPD were performed using a 1-stage approach, treating VPT birth or VLBW and cohort as random effects. MAIN OUTCOMES AND MEASURES Full-scale IQ scores were converted to z scores within each cohort using the combined SD of VPT/VLBW participants and a control group of term-born participants, with scores centered on the mean of the control group. RESULTS A total of 426 records were identified and screened. After exclusions, 13 studies were included in the aggregate meta-analysis. The IPD meta-analysis included 8 of the 9 RECAP and APIC cohorts with adult IQ data. The mean (SD) age among the 8 IPD cohorts was 24.6 (4.3) years, and 1163 participants (54.5%) were women. In unadjusted analyses, VPT/VLBW participants had mean adult IQ scores that were 0.78 SD (95% CI, -0.90 to -0.66 SD) lower than term-born participants, equivalent to a difference of 12 IQ points. Among VPT/VLBW participants, lower gestational age (score difference per week of gestation, 0.11; 95% CI, 0.07-0.14), lower birth weight z scores (score difference per 1.0 SD, 0.21; 95% CI, 0.14-0.28), the presence of neonatal bronchopulmonary dysplasia (score difference, -0.16; 95% CI, -0.30 to -0.02) or any grade of intraventricular hemorrhage (score difference, -0.19; 95% CI, -0.33 to -0.05), and lower maternal educational level (score difference, 0.26; 95% CI, 0.17-0.35) were all significantly associated with lower IQ scores in adulthood. CONCLUSIONS AND RELEVANCE In this IPD meta-analysis, lower gestational age, lower weight for gestational age, neonatal morbidities, and lower maternal educational levels were all important risk factors associated with lower IQ among young adults born VPT or VLBW.
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Affiliation(s)
- Robert Eves
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Marina Mendonça
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Yanyan Ni
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Brian A. Darlow
- Department of Paediatrics, University of Otago at Christchurch, Christchurch, New Zealand
| | - John Horwood
- Department of Psychological Medicine, University of Otago at Christchurch, Christchurch, New Zealand
| | - Lianne J. Woodward
- School of Health Sciences and Child Wellbeing Research Institute, University of Canterbury, Christchurch, New Zealand
| | - Lex W. Doyle
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia,Neonatal Services, Royal Women’s Hospital, Melbourne, Victoria, Australia,Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Jeanie Cheong
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia,Neonatal Services, Royal Women’s Hospital, Melbourne, Victoria, Australia,Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Peter J. Anderson
- Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia,Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, George Davies Centre, Leicester, United Kingdom
| | - Eero Kajantie
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland,PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Petteri Hovi
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland,Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Chiara Nosarti
- Institute of Psychiatry, Psychology and Neuroscience, Department of Child and Adolescent Psychiatry, King’s College London, London, United Kingdom,Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Marit S. Indredavik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kari-Anne I. Evensen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Unit for Physiotherapy Services, Trondheim Municipality, Torgarden, Trondheim, Norway,Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland,Psychology and Welfare Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Jennifer Zeitlin
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, France
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom,Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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12
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Bilgin A, Wolke D, Baumann N, Trower H, Brylka A, Räikkönen K, Heinonen K, Kajantie E, Schnitzlein D, Lemola S. Changes in emotional problems, hyperactivity and conduct problems in moderate to late preterm children and adolescents born between 1958 and 2002 in the United Kingdom. JCPP ADVANCES 2021; 1:e12018. [PMID: 37431476 PMCID: PMC10242980 DOI: 10.1111/jcv2.12018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/09/2021] [Indexed: 11/30/2022] Open
Abstract
Background Preterm birth is a risk factor for the development of emotional and behavioural problems in childhood and adolescence. Given the substantial improvements in neonatal care across decades, it has been expected that the difference in emotional problems, hyperactivity, and conduct problems between moderate to late preterm (MLPT) and full term (FT) children and adolescents have declined in recent years. Methods Data from four UK population-based studies were used: The National Child Development Study (NCDS; 1958), the British Cohort Study (BCS70; 1970), the Avon Longitudinal Study of Parents and Children (ALSPAC, 1991-1992) and the Millennium Cohort Study (MCS; 2000-2002). Emotional problems, hyperactivity and conduct problems were assessed with mother-reports in early childhood (5-7 years), late childhood (10-11 years) and adolescence (14-16 years). Furthermore, emotional problems were self-reported in adolescence in BCS70, ALSPAC and MCS. Results In the most recent cohort, the MLPT group had higher mother-reported emotional problems than those born FT in late childhood and adolescence, whereas there were no differences in self-reported emotional problems in adolescence. Regarding mother-reported hyperactivity symptoms, the MLPT group had higher scores than the FT group in the two most recent cohorts in late childhood and in the most recent cohort in adolescence. Regarding mother-reported conduct problems, MLPT children had significantly higher scores than the FT children in the oldest and in the most recent cohort in late childhood. On the other hand, in adolescence, MLPT children had significantly lower scores in conduct problems in comparison to FT children in the cohort born in 1991-1992. Conclusions Mother-reported emotional problems and hyperactivity symptoms of those born MLPT have increased from the birth years 1958 to 2000-2002 during late childhood and adolescence, whereas self-reported emotional problems were similar in MLPT and FT groups during adolescence from 1970 to 2000-2002. Findings are less consistent regarding conduct problems. The current findings highlight the importance of raising the awareness of teachers about the association between MLPT birth and behavioural and emotional problems in late childhood and adolescence to prevent the long-term negative outcomes associated with the sequalae of MLPT birth.
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Affiliation(s)
- Ayten Bilgin
- School of PsychologyUniversity of KentCanterburyUK
- Department of PsychologyUniversity of WarwickCoventryUK
| | - Dieter Wolke
- Department of PsychologyUniversity of WarwickCoventryUK
- Division of Mental Health and WellbeingWarwick Medical SchoolUniversity of WarwickCoventryUK
| | | | - Hayley Trower
- Department of PsychologyUniversity of WarwickCoventryUK
| | | | - Katri Räikkönen
- Department of Psychology & LogopedicsUniversity of HelsinkiHelsinkiFinland
| | - Kati Heinonen
- Department of Psychology & LogopedicsUniversity of HelsinkiHelsinkiFinland
- Psychology/ Welfare SciencesFaculty of Social SciencesTampere UniversityFinland
| | - Eero Kajantie
- National Institute for Health and WelfareHelsinkiFinland
- Medical Research Center OuluPEDEGO Research UnitOulu University Hospital and University of OuluOuluFinland
- Pediatric Research CenterChildren’s HospitalUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
- Department of Clinical and Molecular MedicineNorwegian University of Science and TechnologyTrondheimNorway
| | - Daniel Schnitzlein
- Institute of Labour EconomicsLeibniz University of HannoverHannoverGermany
- DIW BerlinBerlinGermany
- IZA BonnBonnGermany
| | - Sakari Lemola
- Department of PsychologyUniversity of WarwickCoventryUK
- Department of PsychologyUniversity of BielefeldBielefeldGermany
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13
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Abstract
Twin to twin transfusion syndrome (TTTS) is a common complication that typically presents in the second trimester of pregnancy in 10-15% of monochorionic twins due to net transfer of volume and hormonal substances from one twin to the other across vascular anastomoses on the placenta. Without recognition and treatment, TTTS is the greatest contributor to fetal loss prior to viability in 90-100% of advanced cases. Ultrasound diagnosis of monochorionicity is most reliable in the first trimester and sets the monitoring strategy for this type of twins. The diagnosis of TTTS is made by ultrasound with the findings of polyhydramnios due to volume overload and polyuria in one twin and oligohydramnios due to oliguria of the co-twin. Assessment of bladder filling as well as arterial and venous Doppler patterns are required for staging disease severity. Assessment of fetal cardiac function also provides additional insight into the fetal cardiovascular impacts of the disease as well as help identify fetuses that may require postnatal follow up. Fetoscopic laser ablation of the communicating vascular anastomoses between the twins is the standard treatment for TTTS. It aims to cure the condition by interrupting the link between their circulations and making them independent of one another. Contemporary outcome data after laser surgery suggests survival for both fetuses can be anticipated in up to 65% of cases and survival of a single fetus in up to 88% of cases. However, preterm birth remains a significant contributor to postnatal morbidity and mortality. Long term outcomes of TTTS survivors indicate that up to 11% of children may show signs of neurologic impairment. Strategies to minimize preterm birth after treatment and standardized reporting by laser centers are important considerations to improve overall outcomes and understand the long-term impacts of TTTS.
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Affiliation(s)
- Jena L Miller
- The Johns Hopkins Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA
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14
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Jaekel J, Heuser KM, Zapf A, Roll C, Nuñez FB, Bartmann P, Wolke D, Felderhoff-Mueser U, Huening B. Preterm children's long-term academic performance after adaptive computerized training: an efficacy and process analysis of a randomized controlled trial. Pediatr Res 2021; 89:1492-1499. [PMID: 32919388 PMCID: PMC7588952 DOI: 10.1038/s41390-020-01114-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/04/2020] [Accepted: 07/16/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Adaptive computerized interventions may help improve preterm children's academic success, but randomized trials are rare. We tested whether a math training (XtraMath®) versus an active control condition (Cogmed®; working memory) improved school performance. Training feasibility was also evaluated. METHODS Preterm born first graders, N = 65 (28-35 + 6 weeks gestation) were recruited into a prospective randomized controlled multicenter trial and received one of two computerized trainings at home for 5 weeks. Teachers rated academic performance in math, reading/writing, and attention compared to classmates before (baseline), directly after (post), and 12 months after the intervention (follow-up). Total academic performance growth was calculated as change from baseline (hierarchically ordered-post test first, follow-up second). RESULTS Bootstrapped linear regressions showed that academic growth to post test was significantly higher in the math intervention group (B = 0.25 [95% confidence interval: 0.04-0.50], p = 0.039), but this difference was not sustained at the 12-month follow-up (B = 0.00 [-0.31 to 0.34], p = 0.996). Parents in the XtraMath group reported higher acceptance compared with the Cogmed group (mean difference: -0.49, [-0.90 to -0.08], p = 0.037). CONCLUSIONS Our findings do not show a sustained difference in efficacy between both trainings. Studies of math intervention effectiveness for preterm school-aged children are warranted. IMPACT Adaptive computerized math training may help improve preterm children's short-term school performance. Computerized math training provides a novel avenue towards intervention after preterm birth. Well-powered randomized controlled studies of math intervention effectiveness for preterm school-aged children are warranted.
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Affiliation(s)
- Julia Jaekel
- Child and Family Studies
- Psychology, University of Tennessee Knoxville, Knoxville, TN, USA. .,Psychology, University of Warwick, Coventry, UK.
| | - Katharina M. Heuser
- grid.410718.b0000 0001 0262 7331Pediatrics I, Neonatology, Pediatric Intensive Care, Pediatric Neurology, University Hospital Essen, Essen, Germany ,grid.5570.70000 0004 0490 981XPsychology, Ruhr-University Bochum, Bochum, Germany
| | - Antonia Zapf
- grid.13648.380000 0001 2180 3484Medical Biometry and Epidemiology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Roll
- grid.412581.b0000 0000 9024 6397Vest Children’s Hospital Datteln, University Witten-Herdecke, Datteln, Germany
| | | | - Peter Bartmann
- grid.15090.3d0000 0000 8786 803XChildren’s Hospital, University Hospital Bonn, Bonn, Germany
| | - Dieter Wolke
- grid.7372.10000 0000 8809 1613Psychology, University of Warwick, Coventry, UK
| | - Ursula Felderhoff-Mueser
- grid.410718.b0000 0001 0262 7331Pediatrics I, Neonatology, Pediatric Intensive Care, Pediatric Neurology, University Hospital Essen, Essen, Germany
| | - Britta Huening
- grid.410718.b0000 0001 0262 7331Pediatrics I, Neonatology, Pediatric Intensive Care, Pediatric Neurology, University Hospital Essen, Essen, Germany
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15
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Automated brain MRI metrics in the EPIRMEX cohort of preterm newborns: Correlation with the neurodevelopmental outcome at 2 years. Diagn Interv Imaging 2020; 102:225-232. [PMID: 33187906 DOI: 10.1016/j.diii.2020.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/30/2020] [Accepted: 10/21/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE The purpose of this study was to identify in the EPIRMEX cohort the correlations between MRI brain metrics, including diffuse excessive high signal intensities (DEHSI) obtained with an automated quantitative method and neurodevelopmental outcomes at 2 years. MATERIALS AND METHODS A total of 390 very preterm infants (gestational age at birth≤32 weeks) who underwent brain MRI at term equivalent age at 1.5T (n=338) or 3T (n=52) were prospectively included. Using a validated algorithm, automated metrics of the main brain surfaces (cortical and deep gray matter, white matter, cerebrospinal fluid) and DEHSI with three thresholds were obtained. Linear adjust regressions were performed to assess the correlation between brain metrics with the ages and stages questionnaire (ASQ) score at 2 years. RESULTS Basal ganglia and thalami, cortex and white matter surfaces positively and significantly correlated with the global ASQ score. For all ASQ sub-domains, basal ganglia and thalami surfaces significantly correlated with the scores. DEHSI was present in 289 premature newborns (74%) without any correlation with the ASQ score. Metrics of DEHSI were greater at 3T than at 1.5T. CONCLUSION Brain MRI metrics obtained in our multicentric cohort correlate with the neurodevelopmental outcome at 2 years of age. The quantitative detection of DEHSI is not predictive of adverse outcomes. Our automated algorithm might easily provide useful predictive information in daily practice.
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16
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Differential susceptibility effects of maternal sensitivity in childhood on small for gestational age adults' wealth. Dev Psychopathol 2020; 32:197-203. [PMID: 30704546 DOI: 10.1017/s0954579418001669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Being born small for gestational age (SGA) is considered a developmental vulnerability. Alternatively, SGA may be viewed as a marker for individual susceptibility to environmental experiences. The aim was to test if individuals born SGA are more susceptible to both negative and positive environmental experiences assessed by sensitive parenting in childhood compared with those born appropriate for gestational age (AGA). The target outcome was wealth in young adulthood. A total of 438 participants (SGA, n = 109; AGA, n = 329) were studied as part of the prospective Bavarian Longitudinal Study of neonatal at-risk children. Maternal sensitivity was observed during a standardized mother-child interaction task, and IQ was assessed with the Kaufman Assessment Battery for Children at age 6 years. At age 26, participants' wealth was assessed with a comprehensive composite score. Individuals born SGA were found to be more susceptible to the effects of sensitive parenting after controlling for gestational age and IQ at age 6 years. When maternal sensitivity was lower than average, SGA adults did worse than AGA adults, but when exposed to above-average maternal sensitivity in childhood, they obtained significantly higher wealth than their AGA peers by 26 years of age.
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17
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Mateus V, Vieira EDAP, Martins C, Pachi PR, Osório A. Joint attention abilities in Brazilian preterm and full-term infants. Infant Behav Dev 2020; 60:101451. [PMID: 32512275 DOI: 10.1016/j.infbeh.2020.101451] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 11/24/2022]
Abstract
Joint attention abilities of preterm and full-term Brazilian infants were assessed at 12- and 18-months, age corrected for prematurity. Results showed that preterm infants displayed significantly lower levels of correct responses to others' bids for joint attention at both time-points, compared to full-term infants. Both groups improved their responding to joint attention from 12 to 18 months of age. Contrastingly, prematurity did not impact infants' initiating joint attention behaviors, which remained stable over time for both groups. Findings were discussed in terms of the specific mental processes involved in distinct behavioural dimensions of joint attention.
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Affiliation(s)
- Vera Mateus
- Social and Cognitive Neuroscience Lab, Developmental Disorders Graduate Program, Mackenzie Presbyterian University, Brazil
| | - Elisangela Dos Anjos Paula Vieira
- Social and Cognitive Neuroscience Lab, Developmental Disorders Graduate Program, Mackenzie Presbyterian University, Brazil; Anhanguera University Centre of São Paulo - Pirituba Unit, Brazil
| | - Carla Martins
- School of Psychology, CIPsi, University of Minho, Portugal
| | - Paulo Roberto Pachi
- Faculty of Medical Sciences, Santa Casa de Misericórdia de São Paulo, Brazil
| | - Ana Osório
- Social and Cognitive Neuroscience Lab, Developmental Disorders Graduate Program, Mackenzie Presbyterian University, Brazil.
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18
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Baraldi E, Allodi MW, Löwing K, Smedler AC, Westrup B, Ådén U. Stockholm preterm interaction-based intervention (SPIBI) - study protocol for an RCT of a 12-month parallel-group post-discharge program for extremely preterm infants and their parents. BMC Pediatr 2020; 20:49. [PMID: 32007087 PMCID: PMC6995087 DOI: 10.1186/s12887-020-1934-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 01/16/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Improved neonatal care has resulted in increased survival rates among infants born after only 22 gestational weeks, but extremely preterm children still have an increased risk of neurodevelopmental delays, learning disabilities and reduced cognitive capacity, particularly executive function deficits. Parent-child interaction and parental mental health are associated with infant development, regardless of preterm birth. There is a need for further early interventions directed towards extremely preterm (EPT) children as well as their parents. The purpose of this paper is to describe the Stockholm Preterm Interaction-Based Intervention (SPIBI), the arrangements of the SPIBI trial and the chosen outcome measurements. METHODS The SPIBI is a randomized clinical trial that includes EPT infants and their parents upon discharge from four neonatal units in Stockholm, Sweden. Inclusion criteria are EPT infants soon to be discharged from a neonatal intensive care unit (NICU), with parents speaking Swedish or English. Both groups receive three initial visits at the neonatal unit before discharge during the recruitment process, with a strengths-based and development-supportive approach. The intervention group receives ten home visits and two telephone calls during the first year from a trained interventionist from a multi-professional team. The SPIBI intervention is a strengths-based early intervention programme focusing on parental sensitivity to infant cues, enhancing positive parent-child interaction, improving self-regulating skills and supporting the infant's next small developmental step through a scaffolding process and parent-infant co-regulation. The control group receives standard follow-up and care plus extended assessment. The outcomes of interest are parent-child interaction, child development, parental mental health and preschool teacher evaluation of child participation, with assessments at 3, 12, 24 and 36 months corrected age (CA). The primary outcome is emotional availability at 12 months CA. DISCUSSION If the SPIBI shows positive results, it could be considered for clinical implementation for child-support, ethical and health-economic purposes. Regardless of the outcome, the trial will provide valuable information about extremely preterm children and their parents during infancy and toddlerhood after regional hospital care in Sweden. TRIAL REGISTRATION The study was registered in ClinicalTrials.gov in October 2018 (NCT03714633).
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Affiliation(s)
- Erika Baraldi
- Department of Special Education, Specialpedagogiska institutionen Stockholms universitet, Stockholm University, Frescati Hagväg 10, 106 91 Stockholm, Sweden
| | - Mara Westling Allodi
- Department of Special Education, Specialpedagogiska institutionen Stockholms universitet, Stockholm University, Frescati Hagväg 10, 106 91 Stockholm, Sweden
| | - Kristina Löwing
- Department of Women’s and Children’s Health, Institutionen för kvinnors och barns hälsa, Karolinska Institutet, Karolinska Institutet, 171 77 Stockholm, Sweden
- Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Ann-Charlotte Smedler
- Department of Psychology, Psykologiska institutionen Stockholms universitet, Stockholm University, Frescati Hagväg 8, 106 91 Stockholm, Sweden
| | - Björn Westrup
- Department of Women’s and Children’s Health, Institutionen för kvinnors och barns hälsa, Karolinska Institutet, Karolinska Institutet, 171 77 Stockholm, Sweden
- Neonatology unit, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Ulrika Ådén
- Department of Women’s and Children’s Health, Institutionen för kvinnors och barns hälsa, Karolinska Institutet, Karolinska Institutet, 171 77 Stockholm, Sweden
- Neonatology unit, Karolinska University Hospital, 171 76 Stockholm, Sweden
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19
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Klevebro S, Juul SE, Wood TR. A More Comprehensive Approach to the Neuroprotective Potential of Long-Chain Polyunsaturated Fatty Acids in Preterm Infants Is Needed-Should We Consider Maternal Diet and the n-6:n-3 Fatty Acid Ratio? Front Pediatr 2020; 7:533. [PMID: 31998669 PMCID: PMC6965147 DOI: 10.3389/fped.2019.00533] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 12/09/2019] [Indexed: 12/16/2022] Open
Abstract
There is growing evidence that long-chain polyunsaturated fatty acids (LCPUFAs) are of importance for normal brain development. Adequate supply of LCPUFAs may be particularly important for preterm infants, because the third trimester is an important period of brain growth and accumulation of arachidonic acid (n-6 LCPUFA) and docosahexaenoic acid (n-3 LCPUFA). Fatty acids from the n-6 and n-3 series, particularly, have important functions in the brain as well as in the immune system, and their absolute and relative intakes may alter both the risk of impaired neurodevelopment and response to injury. This narrative review focuses on the potential importance of the n-6:n-3 fatty acid ratio in preterm brain development. Randomized trials of post-natal LCPUFA supplementation in preterm infants are presented. Pre-clinical evidence, results from observational studies in preterm infants as well as studies in term infants and evidence related to maternal diet during pregnancy, focusing on the n-6:n-3 fatty acid ratio, are also summarized. Two randomized trials in preterm infants have compared different ratios of arachidonic acid and docosahexaenoic acid intakes. Most of the other studies in preterm infants have compared formula supplemented with arachidonic acid and docosahexaenoic acid to un-supplemented formula. No trial has had a comprehensive approach to differences in total intake of both n-6 and n-3 fatty acids during a longer period of neurodevelopment. The results from preclinical and clinical studies indicate that intake of LCPUFAs during pregnancy and post-natal development is of importance for neurodevelopment and neuroprotection in preterm infants, but the interplay between fatty acids and their metabolites is complex. The best clinical approach to LCPUFA supplementation and n-6 to n-3 fatty acid ratio is still far from evident, and requires in-depth future studies that investigate specific fatty acid supplementation in the context of other fatty acids in the diet.
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Affiliation(s)
- Susanna Klevebro
- Department of Clinical Science and Education, Stockholm South General Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Sandra E. Juul
- Division of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, United States
| | - Thomas R. Wood
- Division of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, United States
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Abstract
Around 15 million children are born preterm (<37 weeks of gestation) every year. Of these, 15% or 2.25 million are born very preterm (VP; <32 weeks of gestation). Here, the developmental outcomes of VP babies in diverse domains from motor, cognitive, and social function to mental health and well-being throughout childhood and adolescence are reviewed. Their life course adaptation in terms of romantic relationships, employment, and quality of life into adulthood is also considered. Some adverse effects reduce as individuals age, and others remain remarkably stable from childhood into adulthood. We argue that to advance understanding of developmental mechanisms and direct resources for intervention more effectively, social factors need to be assessed more comprehensively, and genetically sensitive designs should be considered with neuroimaging integrated to test alternative developmental models. As current evidence is based almost exclusively on studies from high-income countries, research from low- and middle-income countries is urgently needed.
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Affiliation(s)
- Dieter Wolke
- Department of Psychology, University of Warwick, Coventry CV4 7AL, United Kingdom;,
- Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Marina Mendonça
- Department of Psychology, University of Warwick, Coventry CV4 7AL, United Kingdom;,
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Reyes LM, Jaekel J, Heuser KM, Wolke D. Developmental cascades of social inhibition and friendships in preterm and full‐term children. INFANT AND CHILD DEVELOPMENT 2019. [DOI: 10.1002/icd.2165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Lucia M. Reyes
- Department of Child & Family StudiesUniversity of Tennessee Knoxville Knoxville Tennessee
| | - Julia Jaekel
- Department of Child & Family StudiesUniversity of Tennessee Knoxville Knoxville Tennessee
- Department of PsychologyUniversity of Warwick Coventry UK
| | | | - Dieter Wolke
- Department of PsychologyUniversity of Warwick Coventry UK
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Kroll J, Karolis V, Brittain PJ, Tseng CEJ, Froudist-Walsh S, Murray RM, Nosarti C. Systematic assessment of perinatal and socio-demographic factors associated with IQ from childhood to adult life following very preterm birth. INTELLIGENCE 2019. [DOI: 10.1016/j.intell.2019.101401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Mateus V, Osório A, Martins C. Effects of prematurity on infants' joint attention abilities: A meta‐analytic study. INFANT AND CHILD DEVELOPMENT 2019. [DOI: 10.1002/icd.2145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Vera Mateus
- School of Psychology, CIPsiUniversity of Minho Braga Portugal
| | - Ana Osório
- Social and Cognitive Neuroscience Lab, Developmental Disorders ProgramMackenzie Presbyterian University São Paulo Brazil
| | - Carla Martins
- School of Psychology, CIPsiUniversity of Minho Braga Portugal
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M Reyes L, Jaekel J, Wolke D. Effects of Gestational Age and Early Parenting on Children's Social Inhibition at 6 Years. CHILDREN (BASEL, SWITZERLAND) 2019; 6:E81. [PMID: 31261690 PMCID: PMC6678926 DOI: 10.3390/children6070081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 06/18/2019] [Accepted: 06/25/2019] [Indexed: 11/25/2022]
Abstract
Preterm birth (<37 weeks' gestation) has been associated with problems in social functioning. Whether social inhibition is specifically related to preterm birth and whether early parenting may protect against social inhibition difficulties is unknown. To explore effects of gestational age and early parent-infant relationships on social inhibition, 1314 children born at 26-41 weeks gestational age were studied as part of the prospective Bavarian Longitudinal Study. Early parent-infant relationship quality was assessed postnatally with the parent-infant relationship index. Social inhibition was assessed at age 6 years using an experimental procedure, in which nonverbal and verbal responses were coded into social inhibition categories (disinhibited, normally responsive, inhibited). Multinomial logistic regressions indicated that children with lower gestational age showed more socially disinhibited (nonverbal: OR = 1.27 [95% CI = 1.17-1.40], verbal: OR = 1.23 [95% CI 1.13-1.35]) and inhibited (nonverbal: OR = 1.21 [95% CI = 1.11-1.32], verbal: OR = 1.11 [95% CI = 1.01-1.21]) responses. Good early parent-infant relationships were associated with less verbal disinhibition (OR = 0.70 [95% CI = 0.52-0.93]). Findings suggest that children with lower gestational age are at greater risk to be both socially inhibited and disinhibited. Early parenting affected risk of abnormal social responses. Supporting early parent-infant relationships may reduce preterm children's risk for social difficulties.
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Affiliation(s)
- Lucia M Reyes
- Department of Child and Family Studies, The University of Tennessee, Knoxville, TN 37996, USA
| | - Julia Jaekel
- Department of Child and Family Studies, The University of Tennessee, Knoxville, TN 37996, USA
- Department of Psychology, University of Warwick, Coventry CV47AL, UK
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry CV47AL, UK.
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Jaekel J, Baumann N, Bartmann P, Wolke D. General cognitive but not mathematic abilities predict very preterm and healthy term born adults' wealth. PLoS One 2019; 14:e0212789. [PMID: 30865719 PMCID: PMC6415831 DOI: 10.1371/journal.pone.0212789] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 02/09/2019] [Indexed: 11/27/2022] Open
Abstract
Objective Very preterm (<32 weeks gestation; VP) and/or very low birth weight (<1500g; VLBW) children often have cognitive and mathematic difficulties. It is unknown whether VP/VLBW children’s frequent mathematic problems significantly add to the burden of negative life-course consequences over and above effects of more general cognitive deficits. Our aim was to determine whether negative consequences of VP/VLBW versus healthy term birth on adult wealth are mediated by mathematic abilities in childhood, or rather explained by more general cognitive abilities. Methods 193 VP/VLBW and 217 healthy term comparison participants were studied prospectively from birth to adulthood as part of a geographically defined study in Bavaria (South Germany). Mathematic and general cognitive abilities were assessed at 8 years with standardized tests; wealth information was assessed at 26 years with a structured interview and summarized into a comprehensive index score. All scores were z-standardized. Results At 8 years, VP/VLBW (n = 193, 52.3% male) had lower mathematic and general cognitive abilities than healthy term comparison children (n = 217, 47.0% male). At 26 years, VP/VLBW had accumulated significantly lower overall wealth than term born comparison adults (-0.57 (1.08) versus -0.01 (1.00), mean difference 0.56 [0.36–0.77], p < .001). Structural equation modeling confirmed that VP/VLBW birth (β = -.13, p = .022) and childhood IQ (β = .24, p < .001) both directly predicted adult wealth, but math did not (β = .05, p = .413). Analyses were controlled for small-for-gestational-age (SGA) birth, child sex, and family socioeconomic status. Conclusion This longitudinal study from birth to adulthood shows that VP/VLBW survivors’ general cognitive rather than specific mathematic problems explain their diminished life-course success. These findings are important in order to design effective interventions at school age that reduce the burden of prematurity for those individuals who were born at highest neonatal risk.
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Affiliation(s)
- Julia Jaekel
- Department of Child and Family Studies, University of Tennessee, Knoxville, Tennessee, United States of America
- Department of Psychology, University of Warwick, Coventry, United Kingdom
- * E-mail:
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | | | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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Abstract
OBJECTIVES The aim of this study was to investigate the effects of infant and toddler head growth on intelligence scores from early childhood to adulthood in very preterm (<32 weeks gestational age; VP) and/or very low birth weight (<1500 g; VLBW) and term born individuals. METHODS 203 VP/VLBW and 198 term comparisons were studied from birth to adulthood as part of the prospective geographically defined Bavarian Longitudinal Study (BLS). Head circumference was assessed at birth; 5, 20 months; and 4 years of age. Intelligence was assessed with standardized tests in childhood (6 and 8 years: K-ABC) and at 26 years (Wechsler Adult Intelligence Scale, WAIS). Structural equation modeling (SEM) was used to model the effect of head growth on IQ. RESULTS On average, VP/VLBW had lower head circumference at birth (27.61 cm vs. 35.11 cm, mean difference 7.49, 95% confidence interval [7.09-7.90]) and lower adult intelligence scores (88.98 vs. 102.54, mean difference 13.56 [10.59-16.53]) than term born comparison individuals. Head circumference at birth (e.g., total effect β=.48; p<.001 for adult IQ) and head growth in childhood predicted intelligence development from age 6 to 26 years in both VP/VLBW and term born individuals (70% of variance in adult IQ explained by full model). Effects of gestation and birth weight on intelligence were fully mediated by head circumference and growth. CONCLUSIONS This longitudinal investigation from birth to adulthood indicates head growth as a proxy of brain development and intelligence. Repeated early head circumference assessment adds valuable information when screening for long-term neurocognitive risk. (JINS, 2019, 25, 48#x2013;56).
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Souza ACFDSE, Casais-e-Silva LL, Sena EPD. The influence of prematurity on the development of phonological skills. REVISTA CEFAC 2019. [DOI: 10.1590/1982-0216/201921413118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to check the use of phonological processes in preterm infants. Methods: phonological evaluation was performed through the ABFW Child Language Test in 40 children, aged two to four years, i.e., 20 preterm and 20 full-term children, matched according to age, gender and socioeconomic level. Preterm children were evaluated at the State Center for Prevention and Rehabilitation of People with Disabilities - CEPRED; full-term children were selected and evaluated in a municipal nursery in the city of Salvador, BA, Brazil. The pertinent statistical tests were applied adopting the level of significance lower than 0.05%. Results: in the phonology test, the number of productive phonological processes not expected for the chronological age was statistically significant in the preterm group, especially syllable reduction, consonantal harmony, velar backing and liquid reduction. The high prevalence of cluster reduction and final consonant deletion, though still compatible with chronological age, shows the need to follow up the language acquisition of these children, after the age of four. Conclusion: the results evidenced the difficulty found by preterm infants in the development of phonological skills, emphasizing the importance of early diagnosis and speech-language monitoring in language acquisition.
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Berry MJ, Foster T, Rowe K, Robertson O, Robson B, Pierse N. Gestational Age, Health, and Educational Outcomes in Adolescents. Pediatrics 2018; 142:peds.2018-1016. [PMID: 30381471 DOI: 10.1542/peds.2018-1016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/14/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES As outcomes for extremely premature infants improve, up-to-date, large-scale studies are needed to provide accurate, contemporary information for clinicians, families, and policy makers. We used nationwide New Zealand data to explore the impact of gestational age on health and educational outcomes through to adolescence. METHODS We performed a retrospective cohort study of all births in New Zealand appearing in 2 independent national data sets at 23 weeks' gestation or more. We report on 2 separate cohorts: cohort 1, born January 1, 2005 to December 31, 2015 (613 521 individuals), used to study survival and midterm health and educational outcomes; and cohort 2, born January 1, 1998 to December 31, 2000, and surviving to age 15 years (146 169 individuals), used to study high school educational outcomes. Outcomes described by gestational age include survival, hospitalization rates, national well-being assessment outcomes at age 4 years, rates of special education support needs in primary school, and national high school examination results. RESULTS Ten-year survival increased with gestational age from 66% at 23 to 24 weeks to >99% at term. All outcomes measured were strongly related to gestational age. However, most extremely preterm children did not require special educational support and were able to sit for their national high school examinations. CONCLUSIONS Within a publicly funded health system, high-quality survival is achievable for most infants born at periviable gestations. Outcomes show improvement with gestational ages to term. Outcomes at early-term gestation are poorer than for children born at full term.
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Affiliation(s)
- Mary J Berry
- Departments of Paediatrics and Child Health and .,Capital and Coast District Health Board, Wellington, New Zealand; and
| | - Tim Foster
- Public Health, University of Otago, Wellington, Wellington, New Zealand.,Hawke's Bay District Health Board, Napier, New Zealand
| | - Kate Rowe
- Capital and Coast District Health Board, Wellington, New Zealand; and
| | - Oliver Robertson
- Public Health, University of Otago, Wellington, Wellington, New Zealand
| | - Bridget Robson
- Public Health, University of Otago, Wellington, Wellington, New Zealand
| | - Nevil Pierse
- Public Health, University of Otago, Wellington, Wellington, New Zealand
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Wolke D. Preterm birth: high vulnerability and no resiliency? Reflections on van Lieshout et al. (2018). J Child Psychol Psychiatry 2018; 59:1201-1204. [PMID: 30339283 DOI: 10.1111/jcpp.12971] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/06/2018] [Indexed: 11/28/2022]
Abstract
Globally, 15 million babies are born preterm (<37 weeks gestation) each year, representing 11% of all live births. In the UK, around 7% of children are born preterm each year and around 15% of all preterm born are born more than 8 weeks early (VPT; very preterm) or below 1,500 g birth weight (VLBW). Prematurity is the major cause of infant mortality despite largely increased survival in recent decades attributable to advances in antenatal and neonatal care. Very and extremely preterm born infants (EPT; <28 weeks gestation) often spend many weeks and months in neonatal care before discharge.
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Affiliation(s)
- Dieter Wolke
- Department of Psychology and Warwick Medical School, University of Warwick, Coventry, UK
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30
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Twilhaar ES, de Kieviet JF, Aarnoudse-Moens CSH, van Elburg RM, Oosterlaan J. Academic performance of children born preterm: a meta-analysis and meta-regression. Arch Dis Child Fetal Neonatal Ed 2018; 103:F322-F330. [PMID: 28847871 PMCID: PMC6047144 DOI: 10.1136/archdischild-2017-312916] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 06/28/2017] [Accepted: 07/12/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Advances in neonatal healthcare have resulted in decreased mortality after preterm birth but have not led to parallel decreases in morbidity. Academic performance provides insight in the outcomes and specific difficulties and needs of preterm children. OBJECTIVE To study academic performance in preterm children born in the antenatal steroids and surfactant era and possible moderating effects of perinatal and demographic factors. DESIGN PubMed, Web of Science and PsycINFO were searched for peer-reviewed articles. Cohort studies with a full-term control group reporting standardised academic performance scores of preterm children (<37 weeks of gestation) at age 5 years or older and born in the antenatal steroids and surfactant era were included. Academic test scores and special educational needs of preterm and full-term children were analysed using random effects meta-analysis. Random effects meta-regressions were performed to explore the predictive role of perinatal and demographic factors for between-study variance in effect sizes. RESULTS The 17 eligible studies included 2390 preterm children and 1549 controls. Preterm children scored 0.71 SD below full-term peers on arithmetic (p<0.001), 0.44 and 0.52 SD lower on reading and spelling (p<0.001) and were 2.85 times more likely to receive special educational assistance (95% CI 2.12 to 3.84, p<0.001). Bronchopulmonarydysplasia explained 44% of the variance in academic performance (p=0.006). CONCLUSION Preterm children born in the antenatal steroids and surfactant era show considerable academic difficulties. Preterm children with bronchopulmonarydysplasia are at particular risk for poor academic outcome.
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Affiliation(s)
- E Sabrina Twilhaar
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jorrit F de Kieviet
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cornelieke SH Aarnoudse-Moens
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,Emma Children’s Hospital AMC, Amsterdam, The Netherlands
| | - Ruurd M van Elburg
- Emma Children’s Hospital AMC, Amsterdam, The Netherlands,Nutricia Research, Utrecht, The Netherlands,Department of Paediatrics, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
| | - Jaap Oosterlaan
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,Emma Children’s Hospital AMC, Amsterdam, The Netherlands,Department of Paediatrics, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
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Wiingreen R, Greisen G, Svensson J, Hansen BM. Low gestational age at birth and difficulties in school-A matter of 'dose'. PLoS One 2018; 13:e0198482. [PMID: 29924838 PMCID: PMC6010215 DOI: 10.1371/journal.pone.0198482] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 05/18/2018] [Indexed: 11/19/2022] Open
Abstract
Objectives Several studies suggest a relationship between gestational age at birth and risk of school difficulties. Our study aimed to investigate the association between the entire range of gestational ages and significant school difficulties measured as 1) More than nine hours per week special educational support and 2) Failing to complete compulsory school. Methods A population-based register study including all children attending the Danish compulsory school in 2015/2016 and all live-born infants born in Denmark from 1992 to 1997. Data were collected and linked using multiple registers held by Statistic Denmark. Multiple logistic regression analyses were used to estimate the association between gestational age and significant school difficulties, adjusted for explanatory variables. Results For measurement 1) “Special educational support” 615,789 children entered the analyses after exclusion of those with missing neonatal data. The risk of special educational support increased gradually across the entire range of gestation from 40 to ≤24 weeks: The adjusted odds ratio was 1.07 (95% confidence interval 1.03–1.12) at 39 weeks of gestational and 6.18 (95% confidence interval 5.17–7.39) at gestational ages < 28 weeks. For measurement 2) “Failing to complete compulsory school” the cohort consisted of 374,798 children after exclusion of those who died, had emigrated and/or had missing neonatal data. The risk of failing to complete compulsory school increased across the entire range of gestational ages: The adjusted odds ratio was 1.07 (95% confidence interval 1.04–1.10) at 39 weeks of gestation and 2.99 (95% confidence interval 2.41–3.71) at gestational ages < 28 weeks. In both sets of analyses GA = 40 weeks was used as reference. Conclusions We confirm a clear association between the degree of prematurity and significant school difficulties across the entire range of gestational ages from ≤ 24 to 40 weeks.
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Affiliation(s)
- Rikke Wiingreen
- Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Paediatrics, Herlev Hospital, Herlev, Denmark
- * E-mail:
| | - Gorm Greisen
- Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Hecher K, Gardiner HM, Diemert A, Bartmann P. Long-term outcomes for monochorionic twins after laser therapy in twin-to-twin transfusion syndrome. THE LANCET CHILD & ADOLESCENT HEALTH 2018; 2:525-535. [PMID: 30169324 DOI: 10.1016/s2352-4642(18)30127-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/09/2018] [Accepted: 04/03/2018] [Indexed: 12/28/2022]
Abstract
Twin-to-twin transfusion syndrome typically occurs in the second trimester in 10-15% of monochorionic twin pregnancies. Vascular anastomoses of monochorionic placentae are the underlying cause of the development of the syndrome. If a blood flow imbalance occurs, one fetus becomes the so-called donor twin and the other the recipient. If untreated, perinatal mortality is 80-90%. Fetoscopic laser coagulation of the vascular anastomoses destroys the cause of the syndrome and leads to dual twin survival rates of around 70% and more than 90% of pregnancies with at least one survivor. However, unequal placental sharing, intrauterine death, and severe prematurity are still limiting factors for further improvement of survival rates and decreases in long-term morbidity. Prematurity and neurodevelopmental impairment affect the donor and recipient twins, whereas cardiovascular failure and obstruction of the right ventricular outflow tract are typical complications of recipients, which can lead to long-term morbidity. In this Review, we summarise the literature on follow-up data for survivors of twin-to-twin-transfusion syndrome after laser therapy, including neurodevelopmental outcomes, cardiovascular outcomes, growth, renal function, and ischaemic events, as well as the potential effects of intrauterine programming on later life.
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Affiliation(s)
- Kurt Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Helena M Gardiner
- Fetal Center at Children's Memorial Herman Hospital, McGovern Medical School at UTHealth, University of Texas Health Sciences Center, Houston, TX, USA
| | - Anke Diemert
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Bartmann
- Children's Hospital, University Hospital Bonn, Bonn, Germany
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Towers K. What are the outcomes for children born preterm and how can interventions meet their needs? EDUCATIONAL PSYCHOLOGY IN PRACTICE 2018. [DOI: 10.1080/02667363.2018.1426557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Linsell L, Johnson S, Wolke D, O’Reilly H, Morris JK, Kurinczuk JJ, Marlow N. Cognitive trajectories from infancy to early adulthood following birth before 26 weeks of gestation: a prospective, population-based cohort study. Arch Dis Child 2018; 103:363-370. [PMID: 29146572 PMCID: PMC5890637 DOI: 10.1136/archdischild-2017-313414] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 08/16/2017] [Accepted: 09/18/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine the trajectory of cognitive test scores from infancy to adulthood in individuals born extremely preterm compared with term-born individuals. DESIGN A prospective, population-based cohort study. SETTING 276 maternity units in the UK and Ireland. PATIENTS 315 surviving infants born less than 26 completed weeks of gestation recruited at birth in 1995 and 160 term-born classroom controls recruited at age 6. MAIN OUTCOME MEASURES Bayley Scales of Infant Development-Second Edition (age 2.5); Kaufman Assessment Battery for Children (ages 6/11); Wechsler Abbreviated Scale of Intelligence-Second Edition (age 19). RESULTS The mean cognitive scores of extremely preterm individuals over the period were on average 25.2 points below their term-born peers (95% CI -27.8 to -22.6) and remained significantly lower at every assessment. Cognitive trajectories in term-born boys and girls did not differ significantly, but the scores of extremely preterm boys were on average 8.8 points below those of extremely preterm girls (95% CI -13.6 to -4.0). Higher maternal education elevated scores in both groups by 3.2 points (95% CI 0.8 to 5.7). Within the extremely preterm group, moderate/severe neonatal brain injury (mean difference: -10.9, 95% CI -15.5 to -6.3) and gestational age less than 25 weeks (mean difference: -4.4, 95% CI -8.4 to -0.4) also had an adverse impact on cognitive function. CONCLUSIONS There is no evidence that impaired cognitive function in extremely preterm individuals materially recovers or deteriorates from infancy through to 19 years. Cognitive test scores in infancy and early childhood reflect early adult outcomes.
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Affiliation(s)
- Louise Linsell
- National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Samantha Johnson
- Department of Health Sciences, Centre for Medicine, University of Leicester, Leicester, UK
| | - Dieter Wolke
- Department of Psychology, Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Helen O’Reilly
- Institute of Women’s Health, University College London, London, UK
| | - Joan K Morris
- Centre for Environmental and Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jennifer J Kurinczuk
- National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Neil Marlow
- Institute of Women’s Health, University College London, London, UK
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Edwards AD, Redshaw ME, Kennea N, Rivero-Arias O, Gonzales-Cinca N, Nongena P, Ederies M, Falconer S, Chew A, Omar O, Hardy P, Harvey ME, Eddama O, Hayward N, Wurie J, Azzopardi D, Rutherford MA, Counsell S. Effect of MRI on preterm infants and their families: a randomised trial with nested diagnostic and economic evaluation. Arch Dis Child Fetal Neonatal Ed 2018; 103:F15-F21. [PMID: 28988160 PMCID: PMC5750369 DOI: 10.1136/archdischild-2017-313102] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 08/10/2017] [Accepted: 08/13/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND We tested the hypothesis that routine MRI would improve the care and well-being of preterm infants and their families. DESIGN Parallel-group randomised trial (1.1 allocation; intention-to-treat) with nested diagnostic and cost evaluations (EudraCT 2009-011602-42). SETTING Participants from 14 London hospitals, imaged at a single centre. PATIENTS 511 infants born before 33 weeks gestation underwent both MRI and ultrasound around term. 255 were randomly allocated (siblings together) to receive only MRI results and 255 only ultrasound from a paediatrician unaware of unallocated results; one withdrew before allocation. MAIN OUTCOME MEASURES Maternal anxiety, measured by the State-Trait Anxiety inventory (STAI) assessed in 206/214 mothers receiving MRI and 217/220 receiving ultrasound. Secondary outcomes included: prediction of neurodevelopment, health-related costs and quality of life. RESULTS After MRI, STAI fell from 36.81 (95% CI 35.18 to 38.44) to 32.77 (95% CI 31.54 to 34.01), 31.87 (95% CI 30.63 to 33.12) and 31.82 (95% CI 30.65 to 33.00) at 14 days, 12 and 20 months, respectively. STAI fell less after ultrasound: from 37.59 (95% CI 36.00 to 39.18) to 33.97 (95% CI 32.78 to 35.17), 33.43 (95% CI 32.22 to 34.63) and 33.63 (95% CI 32.49 to 34.77), p=0.02. There were no differences in health-related quality of life. MRI predicted moderate or severe functional motor impairment at 20 months slightly better than ultrasound (area under the receiver operator characteristic curve (CI) 0.74; 0.66 to 0.83 vs 0.64; 0.56 to 0.72, p=0.01) but cost £315 (CI £295-£336) more per infant. CONCLUSIONS MRI increased costs and provided only modest benefits. TRIAL REGISTRATION ClinicalTrials.gov NCT01049594 https://clinicaltrials.gov/ct2/show/NCT01049594. EudraCT: EudraCT: 2009-011602-42 (https://www.clinicaltrialsregister.eu/).
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Affiliation(s)
- A David Edwards
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Maggie E Redshaw
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | | | | | - Nuria Gonzales-Cinca
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Phumza Nongena
- Division of Clinical Sciences, Imperial College London, London, UK
| | - Moegamad Ederies
- Division of Clinical Sciences, Imperial College London, London, UK
| | - Shona Falconer
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Andrew Chew
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Omar Omar
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Pollyanna Hardy
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Merryl Elizabeth Harvey
- Faculty of Health, School of Midwifery, Nursing and Social Work, Birmingham City University, Birmingham, UK
| | - Oya Eddama
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Naomi Hayward
- Division of Clinical Sciences, Imperial College London, London, UK
| | - Julia Wurie
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Denis Azzopardi
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Mary A Rutherford
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Serena Counsell
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
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Lemola S, Oser N, Urfer-Maurer N, Brand S, Holsboer-Trachsler E, Bechtel N, Grob A, Weber P, Datta AN. Effects of gestational age on brain volume and cognitive functions in generally healthy very preterm born children during school-age: A voxel-based morphometry study. PLoS One 2017; 12:e0183519. [PMID: 28850616 PMCID: PMC5574554 DOI: 10.1371/journal.pone.0183519] [Citation(s) in RCA: 18] [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: 04/28/2017] [Accepted: 08/04/2017] [Indexed: 12/19/2022] Open
Abstract
Objective To determine whether the relationship of gestational age (GA) with brain volumes and cognitive functions is linear or whether it follows a threshold model in preterm and term born children during school-age. Study design We studied 106 children (M = 10 years 1 month, SD = 16 months; 40 females) enrolled in primary school: 57 were healthy very preterm children (10 children born 24–27 completed weeks’ gestation (extremely preterm), 14 children born 28–29 completed weeks’ gestation, 19 children born 30–31 completed weeks’ gestation (very preterm), and 14 born 32 completed weeks’ gestation (moderately preterm)) all born appropriate for GA (AGA) and 49 term-born children. Neuroimaging involved voxel-based morphometry with the statistical parametric mapping software. Cognitive functions were assessed with the WISC-IV. General Linear Models and multiple regressions were conducted controlling age, sex, and maternal education. Results Compared to groups of children born 30 completed weeks’ gestation and later, children born <28 completed weeks’ gestation had less gray matter volume (GMV) and white matter volume (WMV) and poorer cognitive functions including decreased full scale IQ, and processing speed. Differences in GMV partially mediated the relationship between GA and full scale IQ in preterm born children. Conclusions In preterm children who are born AGA and without major complications GA is associated with brain volume and cognitive functions. In particular, decreased brain volume becomes evident in the extremely preterm group (born <28 completed weeks’ gestation). In preterm children born 30 completed weeks’ gestation and later the relationship of GA with brain volume and cognitive functions may be less strong as previously thought.
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Affiliation(s)
- Sakari Lemola
- Department of Psychology, University of Warwick, Coventry, United Kingdom
- * E-mail:
| | - Nadine Oser
- Division of Neuropediatrics and Developmental Medicine, University of Basel, Children’s Hospital Basel, Basel, Switzerland
| | | | - Serge Brand
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
- Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, Faculty of Medicine, University of Basel, Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Edith Holsboer-Trachsler
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Nina Bechtel
- Division of Neuropediatrics and Developmental Medicine, University of Basel, Children’s Hospital Basel, Basel, Switzerland
| | - Alexander Grob
- Department of Psychology, University of Basel, Basel, Switzerland
| | - Peter Weber
- Division of Neuropediatrics and Developmental Medicine, University of Basel, Children’s Hospital Basel, Basel, Switzerland
| | - Alexandre N. Datta
- Division of Neuropediatrics and Developmental Medicine, University of Basel, Children’s Hospital Basel, Basel, Switzerland
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Anderson PJ, Treyvaud K, Neil JJ, Cheong JLY, Hunt RW, Thompson DK, Lee KJ, Doyle LW, Inder TE. Associations of Newborn Brain Magnetic Resonance Imaging with Long-Term Neurodevelopmental Impairments in Very Preterm Children. J Pediatr 2017; 187:58-65.e1. [PMID: 28583705 PMCID: PMC5533625 DOI: 10.1016/j.jpeds.2017.04.059] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/23/2017] [Accepted: 04/26/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To determine the relationship between brain abnormalities on newborn magnetic resonance imaging (MRI) and neurodevelopmental impairment at 7 years of age in very preterm children. STUDY DESIGN A total of 223 very preterm infants (<30 weeks of gestation or <1250 g) born at Melbourne's Royal Women's Hospital had a brain MRI scan at term equivalent age. Scans were scored using a standardized system that assessed structural abnormality of cerebral white matter, cortical gray matter, deep gray matter, and cerebellum. Children were assessed at 7 years on measures of general intelligence, motor functioning, academic achievement, and behavior. RESULTS One hundred eighty-six very preterm children (83%) had both an MRI at term equivalent age and a 7-year follow-up assessment. Higher global brain, cerebral white matter, and deep gray matter abnormality scores were related to poorer intelligence quotient (IQ) (Ps < .01), spelling (Ps < .05), math computation (Ps < .01), and motor function (Ps < .001). Higher cerebellum abnormality scores were related to poorer IQ (P = .001), math computation (P = .018), and motor outcomes (P = .001). Perinatal, neonatal, and social confounders had little effect on the relationships between the MRI abnormality scores and outcomes. Moderate-severe global abnormality on newborn MRI was associated with a reduction in IQ (-6.9 points), math computation (-7.1 points), and motor (-1.9 points) scores independent of the other potential confounders. CONCLUSIONS Structured evaluation of brain MRI at term equivalent is predictive of outcome at 7 years of age, independent of clinical and social factors.
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Affiliation(s)
- Peter J Anderson
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
| | - Karli Treyvaud
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia,Department of Psychology & Counselling, La Trobe University, Melbourne, Victoria, Australia
| | - Jeffrey J Neil
- Department of Neurology, Boston Children’s Hospital, Boston, USA,Harvard Medical School, Harvard University, Boston, USA
| | - Jeanie LY Cheong
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia,Newborn Intensive Care, The Royal Women’s Hospital, Melbourne, Victoria, Australia
| | - Rodney W Hunt
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia,Neonatal Medicine, The Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Deanne K Thompson
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Katherine J Lee
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lex W Doyle
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia,Newborn Intensive Care, The Royal Women’s Hospital, Melbourne, Victoria, Australia
| | - Terrie E Inder
- Harvard Medical School, Harvard University, Boston, USA,Pediatric Newborn Medicine, The Brigham and Women’s Hospital, Boston, USA
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Hannula-Sormunen MM, Nanu CE, Laakkonen E, Munck P, Kiuru N, Lehtonen L. Early mathematical skill profiles of prematurely and full-term born children. LEARNING AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.lindif.2017.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Putnick DL, Bornstein MH, Eryigit-Madzwamuse S, Wolke D. Long-Term Stability of Language Performance in Very Preterm, Moderate-Late Preterm, and Term Children. J Pediatr 2017; 181:74-79.e3. [PMID: 27745750 PMCID: PMC5274586 DOI: 10.1016/j.jpeds.2016.09.006] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 08/16/2016] [Accepted: 09/07/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To investigate whether children born very preterm, moderate-late preterm, and term differ in their average level and individual-difference stability in language performance over time. STUDY DESIGN Language was assessed at 5 and 20 months and 4, 6, and 8 years of age in 204 very preterm (<32 weeks' gestation), 276 moderate-late preterm (32-36 weeks' gestation), and 268 term (37-41 weeks' gestation) children from the Bavarian Longitudinal Study. RESULTS Very preterm children consistently performed worse than term-born children, and moderate-late preterm children scored in between. Language performance was stable from 5 months through 8 years in all gestation groups combined, and stability increased between each succeeding wave. Stability was stronger between 5 months and 4 years in very preterm than moderate-late preterm and term groups, but this differential stability attenuated when covariates (child nonverbal intelligence and family socioeconomic status) were controlled. CONCLUSIONS Preterm children, even moderate-late preterm, are at risk for poorer language performance than term-born children. Because individual differences in language performance are increasingly stable from 20 months to 8 years in all gestation groups, pediatricians who attend to preterm children and observe language delays should refer them to language intervention at the earliest age seen.
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Affiliation(s)
- Diane L. Putnick
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
| | - Marc H. Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
| | | | - Dieter Wolke
- Department of Psychology, and Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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Johnson S, Marlow N. Early and long-term outcome of infants born extremely preterm. Arch Dis Child 2017; 102:97-102. [PMID: 27512082 DOI: 10.1136/archdischild-2015-309581] [Citation(s) in RCA: 187] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/12/2016] [Indexed: 01/26/2023]
Abstract
There is no question that birth at extremely low gestational ages presents a significant threat to an infant's survival, health and development. Growing evidence suggests that gestational age may be conceptualised as a continuum in which births before 28 weeks of gestation (extremely preterm: EP) represent the severe end of a spectrum of health and developmental adversity. Although comprising just 1%-2% of all births, EP deliveries pose the greatest challenge to neonatal medicine and to health, education and social services for the provision of ongoing support for survivors with additional needs. Studying the outcomes of these infants remains critical for evaluating and enhancing clinical care, planning long-term support and for advancing our understanding of the life-course consequences of immaturity at birth. Here we review literature relating to early and long-term neurodevelopmental, cognitive, behavioural and educational outcomes following EP birth focusing on key themes and considering implications for intervention.
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Affiliation(s)
- Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Neil Marlow
- Institute for Women's Health, University College London, London, UK
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41
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Born Extremely Low Birth Weight and Health Related Quality of Life into Adulthood. J Pediatr 2016; 179:11-12.e1. [PMID: 27726869 DOI: 10.1016/j.jpeds.2016.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 09/08/2016] [Indexed: 11/23/2022]
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Childhood cognition and lifetime risk of major depressive disorder in extremely low birth weight and normal birth weight adults. J Dev Orig Health Dis 2016; 7:574-580. [PMID: 27453448 DOI: 10.1017/s2040174416000374] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In general population samples, better childhood cognitive functioning is associated with decreased risk of depression in adulthood. However, this link has not been examined in extremely low birth weight survivors (ELBW, <1000 g), a group known to have poorer cognition and greater depression risk. This study assessed associations between cognition at age 8 and lifetime risk of major depressive disorder in 84 ELBW survivors and 90 normal birth weight (NBW, ⩾2500 g) individuals up to 29-36 years of age. The Wechsler Intelligence Scale for Children, Revised (WISC-R), Raven's Coloured Progressive Matrices and the Token Test assessed general, fluid, and verbal intelligence, respectively, at 8 years of age. Lifetime major depressive disorder was assessed using the Mini International Neuropsychiatric Interview at age 29-36 years. Associations were examined using logistic regression adjusted for childhood socioeconomic status, educational attainment, age, sex, and marital status. Neither overall intelligence quotient (IQ) [WISC-R Full-Scale IQ, odds ratios (OR)=0.87, 95% confidence interval (CI)=0.43-1.77], fluid intelligence (WISC-R Performance IQ, OR=0.98, 95% CI=0.48-2.00), nor verbal intelligence (WISC-R Verbal IQ, OR=0.81, 95% CI=0.40-1.63) predicted lifetime major depression in ELBW survivors. However, every standard deviation increase in WISC-R Full-Scale IQ (OR=0.43, 95% CI=0.20-0.92) and Performance IQ (OR=0.46, 95% CI=0.21-0.97), and each one point increase on the Token Test (OR=0.80, 95% CI=0.67-0.94) at age 8 was associated with a reduced risk of lifetime depression in NBW participants. Higher childhood IQ, better fluid intelligence, and greater verbal comprehension in childhood predicted reduced depression risk in NBW adults. Our findings suggest that ELBW survivors may be less protected by superior cognition than NBW individuals.
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44
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Winchester P, Proctor C, Ying J. County-level pesticide use and risk of shortened gestation and preterm birth. Acta Paediatr 2016; 105:e107-15. [PMID: 26613363 PMCID: PMC5067698 DOI: 10.1111/apa.13288] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 11/18/2015] [Accepted: 11/23/2015] [Indexed: 11/30/2022]
Abstract
Aim This study assesses the association between pesticide exposure in pregnancy, preterm birth (PTB) and shortened gestation. Methods Pregnancy information was abstracted from the Centers for Disease Control (CDC) Non‐Public Use Natality Datasets 1990–2005. Pesticide use in maternal county of residence was calculated using California Pesticide Use Reporting (PUR) data 1990–2005. Counties were ranked by pesticide use, and birth months were sorted by peak (May–June) or nonpeak (other months) pesticide use. Multivariate logistical regression models were used. Results Counties with higher pesticide use were associated with higher PTB (low 8.59 ± 0.11%, moderate 9.25 ± 0.07%, high 10.0 ± 0.06%, p's < 0.001) and shorter gestations (low 39.197 ± 0.014 weeks, moderate 39.126 ± 0.011 weeks, high 39.049 ± 0.011 weeks, p's < 0.001). Peak pesticide months were associated with higher PTB (10.01 ± 0.05% vs. 9.36 ± 0.05%, p < 0.001) and shorter gestations (39.069 ± 0.007 weeks vs. 39.122 ± 0.007 weeks, p < 0.001). The pesticide effect on shortened gestation and higher PTB was found in all racial groups. Pesticide use was highest for fungicides > insecticides > fumigants > herbicides > others. Each pesticide type was found to be associated with higher PTB and shorter gestation. Conclusion PTB and shortened gestation were significantly associated with pesticide use in maternal county of residence regardless of race, gestation at birth, and in most risk categories.
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Affiliation(s)
- Paul Winchester
- Section of Neonatal‐Perinatal Medicine Indiana University School of Medicine Indianapolis IN USA
| | - Cathy Proctor
- Section of Neonatal‐Perinatal Medicine Indiana University School of Medicine Indianapolis IN USA
| | - Jun Ying
- Department of Environmental Health University of Cincinnati College of Medicine Cincinnati OH USA
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Breeman LD, Jaekel J, Baumann N, Bartmann P, Wolke D. Attention problems in very preterm children from childhood to adulthood: the Bavarian Longitudinal Study. J Child Psychol Psychiatry 2016; 57:132-40. [PMID: 26287264 DOI: 10.1111/jcpp.12456] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Very preterm (VP; gestational age <32 weeks) and very low birth weight (VLBW; <1500 grams) is related to attention problems in childhood and adulthood. The stability of these problems into adulthood is not known. METHODS The Bavarian Longitudinal Study is a prospective cohort study that followed 260 VP/VLBW and 229 term-born individuals from birth to adulthood. Data on attention were collected at 6, 8, and 26 years of age, using parent reports, expert behavior observations, and clinical ADHD diagnoses. RESULTS At each assessment, VP/VLBW individuals had significantly more attention problems, shorter attention span, and were more frequently diagnosed with ADHD than term-born comparisons. In both VP/VLBW and term-born individuals, overall, attention span increased and attention problems decreased from childhood to adulthood. Attention problems and attention span were more stable over time for VP/VLBW than term-born individuals. Similarly, ADHD diagnoses showed moderate stability from childhood to adulthood in VP/VLBW, but not in term-born individuals. However, when those with severe disabilities were excluded, differences between VP/VLBW and term-born individuals reduced. CONCLUSIONS Despite improvement in attention regulation from childhood to adulthood, children born very preterm remained at increased risk for attention problems in adulthood. In contrast, term-born children with clinical attention problems outgrew these by adulthood. As inattentive behavior of VP/VLBW children may be overlooked by teachers, it may be necessary to raise awareness for school intervention programs that reduce attention problems in VP/VLBW children.
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Affiliation(s)
- Linda D Breeman
- Department of Psychology, University of Warwick, Coventry, UK
| | - Julia Jaekel
- Department of Psychology, University of Warwick, Coventry, UK.,Department of Developmental Psychology, Ruhr-University Bochum, Bochum, Germany
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, UK
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK.,Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
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Jaekel J, Eryigit-Madzwamuse S, Wolke D. Preterm Toddlers' Inhibitory Control Abilities Predict Attention Regulation and Academic Achievement at Age 8 Years. J Pediatr 2016; 169:87-92.e1. [PMID: 26608089 DOI: 10.1016/j.jpeds.2015.10.029] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 08/25/2015] [Accepted: 10/08/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine if adverse effects of preterm birth on attention and academic abilities at age 8 years are mediated by children's inhibitory control abilities. STUDY DESIGN Five hundred fifty-eight children born at 26-41 weeks gestation were studied as part of a prospective geographically defined longitudinal investigation in Germany. Toddlers' inhibitory control abilities were observed at age 20 months. At 8 years, attention and academic abilities were assessed. RESULTS Preterm birth negatively affected children's inhibitory control abilities (B = .25, 95% CI [.11, .39], P < .001) and directly predicted subsequent low attention regulation (B = .23, 95% CI [.07, .38], P < .001) and academic achievement (B = .10, 95% CI [.03, .17], P < .001), after adjusting for other factors. Higher ability to inhibit unwanted behaviors predicted better later attention regulation (B = .24, 95% CI [.07, .41], P < .001) and academic achievement (B = .10, 95% CI [.03, .17], P < .001). CONCLUSIONS The lower a child's gestational age, the lower the inhibitory control and the more likely that the child had poor attention regulation and low academic achievement. Adverse effects of preterm birth on attention and academic outcomes are partially mediated by toddlers' inhibitory control abilities. These findings provide new information about the mechanisms linking preterm birth with long-term attention difficulties and academic underachievement.
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Affiliation(s)
- Julia Jaekel
- Department of Child and Family Studies, University of Tennessee, Knoxville, TN; Department of Developmental Psychology, Ruhr-University Bochum, Bochum, Germany; Department of Psychology, University of Warwick, Coventry, United Kingdom
| | | | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom; Warwick Medical School, University of Warwick, Coventry, United Kingdom.
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