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Oluwole I, Tan JBC, DeSouza S, Hutchinson M, Leigh RM, Cha M, Rodriguez A, Hou G, Rao SS, Narang A, Chou FS. The association between bronchopulmonary dysplasia grade and risks of adverse neurodevelopmental outcomes among preterm infants born at less than 30 weeks of gestation. J Matern Fetal Neonatal Med 2023; 36:2167074. [PMID: 36642443 DOI: 10.1080/14767058.2023.2167074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Bronchopulmonary dysplasia (BPD) is a multifactorial disease with neurodevelopmental implications. This study aims to quantify the risks of adverse neurodevelopmental outcomes for each BPD grade among preterm infants born at less than 30 weeks' gestation. METHODS We retrospectively studied infants who received care in our institution until at least 36 weeks postmenstrual age and had a formal neurodevelopmental assessment in our infant follow-up clinic using the Bayley Scales for Infant and Toddler Development (BSID). We assessed the association between BPD grade and adverse neurodevelopmental outcomes using descriptive statistics and regression models. RESULTS Two hundred and fifty infants, including 89 (35.6%), 87 (34.8%), 65 (20.6%), and 9 (3.6%) with No BPD, Grade 1, Grade 2, and Grade 3 BPD, were included in the study. Small for gestational age, late pulmonary hypertension, dexamethasone administration, and adverse neurodevelopmental outcomes were more common as BPD grade increased. In a logistic regression analysis, Grades 2 and 3, but not Grade 1, BPD were associated with increased odds of a composite adverse neurodevelopmental outcome by 2.7 and 7.2 folds, respectively. A BSID domain-specific analysis showed that higher grades were associated with lower scores in the cognitive, gross motor, and fine motor domains. CONCLUSIONS Grades 2 and 3 BPD, but not Grade 1, correlate with risks of adverse neurodevelopmental outcomes at a grade-dependent manner in our single-center cohort retrospective study. Further validation using a multi-center large cohort is warranted.
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Affiliation(s)
- Izabela Oluwole
- Division of Neonatology, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - John B C Tan
- Division of Neonatology, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA.,Huckleberry Labs, Inc, Irvine, CA, USA
| | - Shirin DeSouza
- Division of General Pediatrics and Pediatric Hospital Medicine, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | | | - Rebekah M Leigh
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Minha Cha
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | | | - Gina Hou
- Division of Neonatology, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Srinandini S Rao
- Division of Neonatology, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Arvind Narang
- Business intelligence and Data Governance, Loma Linda University Health, Loma Linda, CA, USA
| | - Fu-Sheng Chou
- Division of Neonatology, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA.,Clinician Investigator Program, Southern California Permanente Medical Group, Pasadena, CA, USA.,Department of Neonatal-Perinatal Medicine, Kaiser Permanente Riverside Medical Center, Riverside, CA, USA
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2
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Shahramnia MM, Ahmadi A, Saffariyan A, Kamali M, Mohamadi R. Speech sound production, speech intelligibility, and oral-motor outcomes of preterm children: Are they different from full term children? APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:17-25. [PMID: 34967675 DOI: 10.1080/21622965.2021.2017940] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We studied the speech sound abilities of preterm (PT) children. Thirty-one PT and twenty-nine full term (FT) children were recruited. Speech abilities were assessed in single word, story retelling, oral-motor, and intelligibility. PT group had poorer outcomes (Mean = 25.77, SD = 17.19) than FT ones (Mean = 5.9, SD = 4.97) for single word (p < 0.001). They obtained poorer results (Mean = 9.65, SD = 7.85) than FT peers (Mean = 2.95, SD = 3.34) in story retelling (p = 0.002) and intelligibility (Man-Whitney U = 89.50, p = 0.02). They obtained lower values for diadochokesis/patuku/(p < 0.001), isolated (p = 0.001), and sequenced movements (p = 0.02) but not for diadochokesis/patukejk/(p = 0.12). Significant values of correlation were found among single word scores with birth weight (r = -.54, p < .001) and gestational age (r = -0.67, p < .001) and story retelling scores with birth weight (r = -0.40, p = .013) and gestational age (r = -0.64, p < .001). The associations of single word score and maternal (r = -0.02, p = .85) and paternal education (r = -0.10, p = .41) were not significant. No significant relationships were obtained between story retelling score and maternal (r = 0.16, p = .34) and paternal education (r = 0.09, p = .59). The significant values were obtained for associations of intelligibility with isolated (r = 0.54, p = .001), sequenced movements (r = 0.59, p < .001), and diadochokesis/patukejk/(r = 0.39, p = .016) but not significant for intelligibility and diadochokesis/patuku/(r = 0.25, p = .13). Findings implied that speech abilities are weaker in PT children.
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Affiliation(s)
- Mohammad Moez Shahramnia
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Akram Ahmadi
- Department of Speech Therapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, I.R. Iran
| | - Arezoo Saffariyan
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Kamali
- Department of Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Reyhane Mohamadi
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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van Noort-van der Spek IL, Dudink J, Reiss IK, Franken MCJP. Early Speech Sound Production and Its Trajectories in Very Preterm Children From 2 to 4 Years of Age. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1294-1310. [PMID: 35263167 DOI: 10.1044/2021_jslhr-21-00388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Very preterm (VPT) children are at risk for speech and language problems throughout school age. However, little is known about early speech sound production in these children. This study aims to present a detailed description of early speech sound production and its trajectories in VPT children from 2 to 4 years of age. In addition, this study aimed to determine if early speech sound production is associated with speech production and expressive language function at 4 years of age. METHOD In 63 VPT children (< 32 weeks of gestation, 41 boys, mean gestational age = 28.8 weeks, mean birth weight = 1,135 g), speech sound production was assessed by naturalistic speech analysis at 2 years of corrected age and speech and language function by standardized tests at 4 years of age. RESULTS Speech sound production was found to be abnormal in 49% of the VPT children at 2 years of age and in 19% at 4 years of age. Four different speech production trajectories from 2 to 4 years of age could be identified: a normal trajectory, an abnormal trajectory, a catch-up trajectory, and a growing-into-deficit trajectory. Early speech production, defined by the number of acquired consonants at 2 years of age, significantly predicted the word production score at 4 years of age and the sentence production score at 4 years of age. CONCLUSIONS Compared to the general population, an alarmingly high proportion of VPT children showed speech production problems at 2 years of age. About half of these children showed persistent speech problems at 4 years of age. Moreover, these problems were associated with expressive language problems at the age of 4 years. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19310822.
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Affiliation(s)
- Inge L van Noort-van der Spek
- Department of Otorhinolaryngology, Sophia Children's Hospital, Erasmus Medical University Center, Rotterdam, the Netherlands
| | - Jeroen Dudink
- Division of Neonatology, Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical University Center, Rotterdam, the Netherlands
- Division of Neonatology, Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Centre, Utrecht, the Netherlands
| | - Irwin K Reiss
- Division of Neonatology, Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical University Center, Rotterdam, the Netherlands
| | - Marie-Christine J P Franken
- Department of Otorhinolaryngology, Sophia Children's Hospital, Erasmus Medical University Center, Rotterdam, the Netherlands
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Lalitha R, Bitar E, Hicks M, Hyderi A, Kumaran K. Pulmonary artery dopplers for early prediction of risk for bronchopulmonary dysplasia in extremely low birth weight babies. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:385-392. [PMID: 35218035 DOI: 10.1002/jcu.23161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/25/2022] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The early abnormal pulmonary vasoreactivity observed in babies at risk of Bronchopulmonary dysplasia (BPD) increases the pulmonary vascular resistance. This can be assessed non-invasively using Time to Peak Velocity:Right Ventricular Ejection Time ratio (TPV:RVET) measured from pulmonary artery Doppler waveform obtained using echocardiogram. We postulate that screening for this early can predict BPD in this cohort. The objective of the study was to determine the utility of TPV:RVET in early prediction of BPD in Extremely Low Birth Weight (ELBW) babies born less than 1250grams Birth Weight. METHODS This was a single-center retrospective cohort study of ELBW babies born<29 weeks over 4 year period who had echocardiogram between 7-21 days of life. TPV:RVET ratio was measured from pulmonary artery Doppler waveform obtained using echocardiogram. The main outcome was BPD at 36 weeks corrected gestation. The predictive ability of TPV:RVET (cut off 0.34) for subsequent development of BPD was analyzed using ROC. RESULTS Of 589 ELBW<29 weeks, 207 babies were eligible. BPD was found in 60.4%. The TPV:RVET at 0.34 had sensitivity 76.8% (95%CI 68.4-83.9), specificity 85.4% (95%CI 75.8-92.2), positive predictive value 88.9% (95%CI 81.4-94.1), negative predictive value 70.7% (95%CI 60.7-79), and ROC area 0.811 (95%CI 0.757-0.864). Odds ratio of having BPD for TPV:RVET at 0.34 was 19.9 (95%CI 8.19-48.34) and increased by 1.07 (95%CI 1.05-1.09) with every additional days of mechanical ventilation. TPV:RVET ratio had 92.75% inter-observer agreement with kappa 0.83. CONCLUSION TPV:RVET ratio is a good and reliable early screening tool for subsequent development of BPD in ELBW babies with substantial inter-observer agreement.
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Affiliation(s)
- Renjini Lalitha
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Western Ontario, London, Ontario, Canada
| | - Eyad Bitar
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew Hicks
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Abbas Hyderi
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Kumar Kumaran
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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Ni Y, Mendonça M, Baumann N, Eves R, Kajantie E, Hovi P, Tikanmäki M, Räikkönen K, Heinonen K, Indredavik MS, Evensen KAI, Johnson S, Marlow N, Wolke D. Social Functioning in Adults Born Very Preterm: Individual Participant Meta-analysis. Pediatrics 2021; 148:peds.2021-051986. [PMID: 34702720 DOI: 10.1542/peds.2021-051986] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 11/24/2022] Open
Abstract
CONTEXT There is a lack of research on individual perceptions of social experiences and social relationships among very preterm (VP) adults compared with term-born peers. OBJECTIVE To investigate self-perceived social functioning in adults born VP (<32 weeks' gestation) and/or with very low birth weight (VLBW) (<1500g) compared with term-born adults (≥37 weeks' gestation) using an individual participant data (IPD) meta-analysis. DATA SOURCES Two international consortia: Research on European Children and Adults born Preterm and Adults Born Preterm International Collaboration. STUDY SELECTION Cohorts with outcomes assessed by using the Adult Self-Report Adaptive Functioning scales (friends, spouse/partner, family, job, and education) in both groups. DATA EXTRACTION IPD from 5 eligible cohorts were collected. Raw-sum scores for each scale were standardized as z scores by using mean and SD of controls for each cohort. Pooled effect size was measured by difference (Δ) in means between groups. RESULTS One-stage analyses (1285 participants) revealed significantly lower scores for relationships with friends in VP/VLBW adults compared with controls (Δ -0.37, 95% confidence interval [CI]: -0.61 to -0.13). Differences were similar after adjusting for sex, age, and socioeconomic status (Δ -0.39, 95% CI: -0.63 to -0.15) and after excluding participants with neurosensory impairment (Δ -0.34, 95% CI: -0.61 to -0.07). No significant differences were found in other domains. LIMITATIONS Generalizability of research findings to VP survivors born in recent decades. CONCLUSIONS VP/VLBW adults scored their relationship with friends lower but perceived their family and partner relationships, as well as work and educational experiences, as comparable to those of controls.
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Affiliation(s)
- Yanyan Ni
- Department of Psychology, University of Warwick, Coventry, United Kingdom.,EGA Institute for Women's Health, University College London, London, United Kingdom
| | - Marina Mendonça
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Robert Eves
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Eero Kajantie
- Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, Helsinki, Finland.,Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology, Faculty of Medicine, 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
| | - Petteri Hovi
- Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, Helsinki, Finland.,Children's Hospital, Helsinki University Hospital
| | - Marjaana Tikanmäki
- Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, Helsinki, Finland.,Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology, Faculty of Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Programs in Psychology and Comparative Social Policy and Welfare, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - 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, Trondheim, Norway.,Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, George Davies Centre, Leicester, United Kingdom
| | - Neil Marlow
- EGA Institute for Women's Health, University College London, London, United Kingdom
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom
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Pérez-Pereira M. Prevalence of Language Delay among Healthy Preterm Children, Language Outcomes and Predictive Factors. CHILDREN-BASEL 2021; 8:children8040282. [PMID: 33917554 PMCID: PMC8067481 DOI: 10.3390/children8040282] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/12/2021] [Accepted: 04/02/2021] [Indexed: 11/16/2022]
Abstract
Language delay (LD) and its relationship with later language impairment in preterm children is a topic of major concern. Previous studies comparing LD in preterm (PT) and full-term (FT) children were mainly carried out with samples of extremely preterm and very preterm children (sometimes with additional medical problems). Very few of them were longitudinal studies, which is essential to understand developmental relationships between LD and later language impairment. In this study, we compare the prevalence of LD in low-risk preterm children to that of FT children in a longitudinal design ranging from 10 to 60 months of age. We also analyze which variables are related to a higher risk of LD at 22, 30 and 60 months of age. Different language tests were administered to three groups of preterm children of different gestational ages and to one group of full-term children from the ages of 10 to 60 months. ANOVA comparisons between groups and logistic regression analyses to identify possible predictors of language delay at 22, 30 and 60 months of age were performed. The results found indicate that there were practically no differences between gestational age groups. Healthy PT children, therefore, do not have, in general terms, a higher risk of language delay than FT children. Previous language delay and cognitive delay are the strongest and longest-lasting predictors of later language impairment. Other factors, such as a scarce use of gestures at 10 months or male gender, affect early LD at 22 months of age, although their effect disappears as children grow older. Low maternal education appears to have a late effect. Gestational age does not have any significant effect on the appearance of LD.
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Affiliation(s)
- Miguel Pérez-Pereira
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
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Sanchez K, Boyce JO, Mei C, St John M, Smith J, Leembruggen L, Mills S, Spittle AJ, Morgan AT. Communication in children born very preterm: a prospective cohort study. Dev Med Child Neurol 2020; 62:506-512. [PMID: 31538339 DOI: 10.1111/dmcn.14360] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2019] [Indexed: 11/29/2022]
Abstract
AIM To compare language, speech, and voice of children born preterm and at term, and determine relevant predictors of outcome. METHOD Three hundred infants (150 males, 150 females; 149 born at <30wks' gestation, 151 term-born) were prospectively recruited at birth from the Royal Women's Hospital. We administered the Preschool Language Scales, Fifth Edition, Diagnostic Evaluation of Articulation and Phonology, Grade Roughness Breathiness Asthenia Strain Scale, and Pediatric Voice Handicap Index at 3 years, and compared groups. We examined hypothesized predictors in children born preterm: gestational age at birth, birthweight, sex, chronic lung disease, high social risk, multilingualism, neurodevelopmental diagnosis, and oromotor feeding. RESULTS Children born preterm had poorer language than children born at term (coefficient -5.43). Speech and voice were similar between groups (coefficients -0.70 to 1.63). Chronic lung disease predicted voice (coefficient 6.05); male sex (coefficients 4.54-6.18), high social risk (coefficient -6.02 to -9.30), and neurodevelopmental diagnosis (coefficients -16.42 to -20.61) predicted language. INTERPRETATION Children born before 30 weeks' gestation had poorer language than children born at term. Children born preterm with neurodevelopmental disabilities or high social risk experience poorer language outcomes, and would benefit from enrichment of their language environment. WHAT THIS PAPER ADDS Speech and voice outcomes were similar between children born preterm and at term. Male sex, high social risk, and neurodevelopmental diagnosis predicted language outcomes.
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Affiliation(s)
- Katherine Sanchez
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,University of Melbourne, Parkville, Victoria, Australia
| | - Jessica O Boyce
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,University of Melbourne, Parkville, Victoria, Australia
| | - Cristina Mei
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Miya St John
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,University of Melbourne, Parkville, Victoria, Australia
| | - Jodie Smith
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,University of Melbourne, Parkville, Victoria, Australia
| | - Linda Leembruggen
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Stephanie Mills
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Alicia J Spittle
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,University of Melbourne, Parkville, Victoria, Australia.,The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Angela T Morgan
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,University of Melbourne, Parkville, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia
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Peyton C, Einspieler C, Fjørtoft T, Adde L, Schreiber MD, Drobyshevsky A, Marks JD. Correlates of Normal and Abnormal General Movements in Infancy and Long-Term Neurodevelopment of Preterm Infants: Insights from Functional Connectivity Studies at Term Equivalence. J Clin Med 2020; 9:E834. [PMID: 32204407 PMCID: PMC7141532 DOI: 10.3390/jcm9030834] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/14/2020] [Accepted: 03/17/2020] [Indexed: 12/19/2022] Open
Abstract
Preterm infants born before 32 weeks gestation have increased risks for neurodevelopmental impairment at two years of age. How brain function differs between preterm infants with normal or impaired development is unknown. However, abnormal spontaneous motor behavior at 12-15 weeks post-term age is associated with neurodevelopmental impairment. We imaged brain blood oxygen level-dependent signals at term-equivalent age in 62 infants born at <32 weeks gestation and explored whether resting state functional connectivity (rsFC) differed with performances on the General Movement Assessment (GMA) at 12-15 weeks, and Bayley III scores at two years of corrected age. Infants with aberrant general movements exhibited decreased rsFC between the basal ganglia and regions in parietal and frontotemporal lobes. Infants with normal Bayley III cognitive scores exhibited increased rsFC between the basal ganglia and association cortices in parietal and occipital lobes compared with cognitively impaired children. Infants with normal motor scores exhibited increased rsFC between the basal ganglia and visual cortices, compared with children with motor impairment. Thus, the presence of abnormal general movements is associated with region-specific differences in rsFC at term. The association of abnormal long-term neurodevelopmental outcomes with decreased rsFC between basal ganglia and sub-score specific cortical regions may provide biomarkers of neurodevelopmental trajectory and outcome.
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Affiliation(s)
- Colleen Peyton
- Department of Pediatrics, University of Chicago, Chicago, IL 60422, USA
- Department of Physical Therapy and Human Movement Science and the Department of Pediatrics, Northwestern University, Chicago, IL 60611, USA
| | - Christa Einspieler
- Research Unit IDN, Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz 8036, Austria;
| | - Toril Fjørtoft
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway; (T.F.); (L.A.)
- Clinics of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| | - Lars Adde
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway; (T.F.); (L.A.)
- Clinics of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| | | | | | - Jeremy D. Marks
- Department of Pediatrics, University of Chicago, Chicago, IL 60422, USA
- Department of Neurology, University of Chicago, Chicago, IL 60422, USA
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Language Skills in Children Born Preterm (<30 Wks' Gestation) Throughout Childhood: Associations With Biological and Socioenvironmental Factors. J Dev Behav Pediatr 2019; 40:735-742. [PMID: 31613841 DOI: 10.1097/dbp.0000000000000742] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To examine the individual and collective contribution of biological and socioenvironmental factors associated with language function at 2, 5, 7, and 13 years in children born preterm (<30 weeks' gestation or <1250 g birth weight). METHODS Language function was assessed as part of a prospective longitudinal study of 224 children born preterm at 2, 5, 7, and 13 years using age-appropriate tools. Language Z-scores were generated based on a contemporaneous term-born control group. A selection of biological factors (sex, small for gestational age, bronchopulmonary dysplasia, infection, and qualitatively defined brain injury) and early socioenvironmental factors at age 2 years (primary income earner employment status and type, primary caregiver education level, English as a second language, parental mental health history, parent sensitivity and facilitation, and parent-child synchrony) was chosen a priori. Associations were assessed using univariable and multivariable linear regression models applied to outcomes at each time point. RESULTS Higher primary caregiver education level, greater parent-child synchrony, and parent sensitivity were independently associated with better language function across childhood. Socioenvironmental factors together explained an increasing percentage of the variance (9%-18%) in language function from 2 to 13 years of age. In comparison, there was little evidence for associations between biological factors and language function, even during early childhood years. CONCLUSION This study highlights the importance of socioenvironmental factors over biological factors for language development throughout childhood. Some of these socioenvironmental factors are potentially modifiable, and parent-based interventions addressing parenting practices and education may benefit preterm children's language development.
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10
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Imgrund CM, Loeb DF, Barlow SM. Expressive Language in Preschoolers Born Preterm: Results of Language Sample Analysis and Standardized Assessment. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:884-895. [PMID: 30986137 PMCID: PMC6802888 DOI: 10.1044/2018_jslhr-l-18-0224] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/01/2018] [Accepted: 10/12/2018] [Indexed: 06/02/2023]
Abstract
Purpose Preschoolers born preterm are at an increased risk for the development of language impairments. The primary objective of this study was to document the expressive language skills of preschoolers born preterm through 2 assessment procedures, language sample analysis, and standardized assessment. A secondary objective was to investigate the role of nonlinguistic factors in standardized assessment scores. Method The language skills of 29 children born preterm (mean gestational age of 31 weeks) were compared to a group of 29 preschoolers born full term. Language samples were collected during free play and objective measures of semantic and grammatical skills were calculated. Likewise, grammatical and semantic measures of language were obtained from a standardized assessment. Information on nonlinguistic factors, including attention, hyperactivity, and nonverbal intelligence quotient, was also collected. Results The results of analyses of variance indicated that the children in the PT group had significantly poorer performance than the children born full term on all of the measures of language skill obtained from the language sample analysis. Group differences were found for only 1 measure of language skill obtained from the standardized assessments. Nonverbal factors were not found to account for group differences in assessment scores. Conclusions Generally, the children born preterm performed more poorly when language skill was measured via language sample analysis than standardized assessment. These findings underscore the importance of using language sample analysis in conjunction with standardized assessment in the evaluation of children's developing language skills.
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Affiliation(s)
- Caitlin M. Imgrund
- Department of Communication Sciences and Disorders, Florida Atlantic University, Boca Raton
| | - Diane F. Loeb
- Department of Communication Sciences and Disorders, Baylor University, Waco, TX
| | - Steven M. Barlow
- Department of Special Education and Communication Disorders, University of Nebraska–Lincoln
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Brósch-Fohraheim N, Fuiko R, Marschik PB, Resch B. The influence of preterm birth on expressive vocabulary at the age of 36 to 41 months. Medicine (Baltimore) 2019; 98:e14404. [PMID: 30732188 PMCID: PMC6380758 DOI: 10.1097/md.0000000000014404] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Children born preterm (PT) have a higher risk of language delays than children born full-term (FT). Expressive vocabulary plays a central role in language development, as later grammar ability can be predicted from earlier vocabulary size.To determine the effects of preterm birth on expressive vocabulary at the age of 36 to 41 months.Cross-sectional study of 27 PT (children with a gestational age of ≤ 32 + 0 weeks and/or a birth weight ≤ 1500 g) and 26 FT children (from several kindergartens in Vienna, Austria). The groups were matched regarding age, sex, and monolingual Austrian German speech. They were all examined using the active vocabulary test (AWST-R) and the development test, Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III).The AWST-R revealed significantly lower scores (46% vs 52%, P = .027) for PT children. The Bayley-III revealed significantly lower scores in language development (mean 96.3 ± 11.81 vs 105.1 ± 6.24, P = .002) and the expressive communication subscale (8.78 ± 2.01 vs 10.69 ± 1.49, P < .001) for PT children, but no differences in cognitive development (98.5 ± 11.08 vs 100.8 ± 6.43, P = .369) or on the receptive communication subscale (10.15 ± 2.23 vs 11.08 ± 1.09, P = .060).Preterm children tested had less expressive vocabulary (AWST-R and Bayley-III) than those born full-term, while test results in their cognitive development and receptive communication (Bayley-III) did not differ.
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Affiliation(s)
- Nina Brósch-Fohraheim
- Department of Paediatrics and Adolescent Medicine, Wilhelminenspital Vienna
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
| | - Renate Fuiko
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna
| | - Peter B. Marschik
- iDN – interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz
- Department of Child and Adolescent Psychiatry and Psychotherapy, iDN – interdisciplinary Developmental Neuroscience, University Medical Center of Goettingen, Goettingen, Germany
- Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Bernhard Resch
- Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
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12
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Abstract
Bronchopulmonary dysplasia (BPD) is a common complication of extreme prematurity, and its rate is not improving, despite advances in perinatal intensive care. Children with BPD diagnosed in the neonatal period have higher risks for hospitalizations for respiratory problems over the first few years of life, and they have more asthma in later childhood. Neonates diagnosed with BPD have substantial airway obstruction on lung function testing in later childhood and early adulthood, and many are destined to develop adult chronic obstructive pulmonary disease. Survivors with neonatal BPD have more adverse motor function, worse cognitive development and poorer academic progress than those without BPD. Long-term outcomes for children born extremely preterm will improve if the rate of BPD can be substantially reduced.
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Affiliation(s)
- Jeanie L Y Cheong
- Neonatal Services, Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
| | - Lex W Doyle
- Neonatal Services, Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
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13
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Nguyen TNN, Spencer-Smith M, Haebich KM, Burnett A, Scratch SE, Cheong JLY, Doyle LW, Wiley JF, Anderson PJ. Language Trajectories of Children Born Very Preterm and Full Term from Early to Late Childhood. J Pediatr 2018; 202:86-91.e1. [PMID: 30054166 DOI: 10.1016/j.jpeds.2018.06.036] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/10/2018] [Accepted: 06/13/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To identify distinct language trajectories of children born very preterm and full term from 2 to 13 years of age and examine predictors for the identified trajectories. STUDY DESIGN A cohort of 224 children born very preterm and 77 full term controls recruited at birth were followed up at ages 2, 5, 7, and 13 years. The number of distinct language trajectories was examined using latent growth mixture modeling allowing for linear and quadratic time trends. Potential predictors in the neonatal period (eg, birth group, sex, and medical risk) and at 2 years (ie, social risk and use of allied health services) for the language trajectories were tested using multinomial logistic regression. RESULTS Five distinct language trajectories were identified across childhood: stable normal (32% of study cohort), resilient development showing catch-up (36%), precocious language skills (7%), stable low (17%), and high-risk (5%) development. The very preterm group was 8 times more likely to have a language trajectory that represented poorer language development compared with full term controls (very preterm, 40%; full term, 6%). Greater social risk and use of allied health services were associated with poorer language development. CONCLUSIONS Variable language trajectories were observed, with a substantial proportion of children born very preterm exhibiting adverse language development. These findings highlight the need for monitoring language skills in children born very preterm before school entry and across middle childhood.
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Affiliation(s)
- Thi-Nhu-Ngoc Nguyen
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Megan Spencer-Smith
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Kristina M Haebich
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Alice Burnett
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia; Newborn Research, Royal Women's Hospital, Melbourne, Australia; Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia
| | - Shannon E Scratch
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada; Department of Pediatrics, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Jeanie L Y Cheong
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia; Department of Obstetrics and Gynecology, Royal Women's Hospital, Melbourne, Australia
| | - Lex W Doyle
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia; Newborn Research, Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynecology, Royal Women's Hospital, Melbourne, Australia
| | - Joshua F Wiley
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
| | - Peter J Anderson
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
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Lapcharoensap W, Lee HC, Nyberg A, Dukhovny D. Health Care and Societal Costs of Bronchopulmonary Dysplasia. Neoreviews 2018; 19:e211-e223. [PMID: 33384574 DOI: 10.1542/neo.19-4-e211] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Despite significant technological advances and increasing survival of premature infants, bronchopulmonary dysplasia (BPD) continues to be the most prevalent major morbidity in surviving very low-birthweight infants. Infants with BPD are often sicker, require longer stays in the NICU, and accumulate greater hospital costs. However, care of the infant with BPD extends beyond the time spent in the NICU. This article reviews the costs of BPD in the health-care setting, during the initial hospitalization and beyond, and the long-term neurodevelopmental impact of BPD, as well as the impact on a family caring for a child with BPD.
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Affiliation(s)
| | - Henry C Lee
- Department of Pediatrics, Stanford University, Stanford, CA
| | - Amy Nyberg
- March of Dimes NICU Family Support Coordinator, Helen DeVos Children's Hospital, Grand Rapids, MI
| | - Dmitry Dukhovny
- Department of Pediatrics, Oregon Health and Science University, Portland, OR
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15
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Zimmerman E. Do Infants Born Very Premature and Who Have Very Low Birth Weight Catch Up With Their Full Term Peers in Their Language Abilities by Early School Age? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:53-65. [PMID: 29255846 DOI: 10.1044/2017_jslhr-l-16-0150] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 08/03/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE This study examined the extent to which children born preterm (< 37 weeks) and/or who have low birth weight (< 2,500 g) catch up with their full term peers in terms of their language abilities at early school age (≥ 5 to < 9 years). METHOD A systematic literature search identified empirical studies that fit the inclusion criteria. Data from the tests/questionnaires used for meta-analysis spanned the following language categories: total language score, expressive language, receptive language, pragmatics, phonological awareness, and grammar. The means (standard deviations) were extracted from the studies and were converted to mean difference and 95% confidence intervals to test for overall effect. RESULTS Sixteen studies met the inclusionary criteria, for a total of 2,739 participants, of which 1,224 were born full term and 1,515 were born preterm. It is important to note that the preterm cohort represented very preterm infants who have a very low birth weight. The meta-analysis found that preterm infants scored significantly worse on total language (p < .001), receptive language (p < .001), expressive language (p < .001), phonological awareness (p < .001), and grammar (p = .03) than their full term peers. However, preterm infants did not score significantly worse than their peers on their pragmatics (p = .19). CONCLUSIONS Children born VPT and who have VLBW perform worse than their peers on their total language, receptive language, expressive language, phonological awareness, and grammar abilities by early school age. This information is important for speech-language pathologists to consider as children born prematurely reach school age.
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Affiliation(s)
- Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
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16
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Pascoe M, Bissessur D, Mayers P. Mothers' perceptions of their premature infant's communication: A description of two cases. Health SA 2016. [DOI: 10.1016/j.hsag.2015.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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17
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Pérez-Pereira M, Fernández P, Resches M, Gómez-Taibo ML. Does temperament influence language development? Evidence from preterm and full-term children. Infant Behav Dev 2015; 42:11-21. [PMID: 26615329 DOI: 10.1016/j.infbeh.2015.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 09/30/2015] [Accepted: 10/03/2015] [Indexed: 10/22/2022]
Abstract
The aims of this study are: (1) to describe language and temperament characteristics of one group of low risk preterm (PR) children and a group of full-term (FT) children and (2) to identify those factors which can predict language outcomes at 30 months of age, with special attention on temperament. There is evidence of differences between very or extremely PR and FT children in relation to characteristics of temperament and language development. However, not many studies have been carried out with healthy PR children. The participants were 142 low risk PR children (mean gestational age (GA): 32.60 weeks) and 49 FT children (mean GA 39.84 weeks). The temperament of the children was assessed at 10 months of age through the Infant Behavior Questionnaire-Revised (IBQ-R). At 22 months of age the cognitive development of the children was assessed through the Spanish adaptation of the Batelle Developmental Inventory (BDI). In order to assess the children's language development the Galician adaptation of the MacArthur-Bates CDI was applied at 30 months of age. In addition, socio-demographic information about the children and their families was gathered at birth. The results indicate that there were no significant differences in the language measures of interest (word production, MLU3, and sentence complexity) between groups. The only differences found between the PR and the FT children in the IBQ-R were restricted to the smiling and laughter and the fear subscales. Hierarchical regression analyses performed indicate that GA did not have any predictive effect on language measures taken at 30 months. Cognitive scores were an important predictor of language measures, although certain temperament subscales contributed in a significant way to the variance of language measures, particularly low intensity pleasure, approach, high intensity pleasure, sadness, and vocal reactivity. Therefore, extroverted (positive affectivity) temperament seems to be beneficial for language development.
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Affiliation(s)
| | - Pilar Fernández
- University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Mariela Resches
- University of Santiago de Compostela, Santiago de Compostela, Spain
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18
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Rojas-Reyes MX, Lozano JM, Solà I, Soll R. Overview of ventilation strategies for the early management of intubated preterm infants. Hippokratia 2015. [DOI: 10.1002/14651858.cd011663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Maria Ximena Rojas-Reyes
- Pontificia Universidad Javeriana; Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine; Cr. 7 #40-62, 2nd floor Bogota DC Colombia
| | - Juan Manuel Lozano
- Herbert Wertheim College of Medicine, Florida International University; Division of Research & Information; 11200 SW 8th Street Modesto Maidique Campus, AHC1, #443 Miami Florida USA 33178
| | - Ivan Solà
- CIBER Epidemiología y Salud Pública (CIBERESP); Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau); Sant Antoni Maria Claret 171 - Edifici Casa de Convalescència Barcelona Catalunya Spain 08041
| | - Roger Soll
- University of Vermont Medical Center; Division of Neonatal-Perinatal Medicine; 111 Colchester Avenue Burlington Vermont USA 05401
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Amin SB, Vogler-Elias D, Orlando M, Wang H. Auditory neural myelination is associated with early childhood language development in premature infants. Early Hum Dev 2014; 90:673-8. [PMID: 25194836 PMCID: PMC4301398 DOI: 10.1016/j.earlhumdev.2014.07.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 07/23/2014] [Accepted: 07/30/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Auditory neural myelination (ANM) as evaluated by auditory brainstem evoked response (ABR) during the neonatal period has been used as a surrogate outcome for long-term neurodevelopment. The validity of ANM as a surrogate outcome for long-term neurodevelopment has not been well studied. AIM Evaluate the association of ABR I-V interpeak latency (IPL), an index of ANM, at 35 week postmenstrual age (PMA) with language outcome at 3 years of age. DESIGN Prospective study. SUBJECTS 24-33 week gestational age (GA) infants were eligible if they did not meet exclusion criteria: craniofacial malformation, chromosomal disorders, deafness, auditory dys-synchrony, TORCH infection, or non-English speaking parents. Infants with malignancy, head injury, encephalopathy, meningitis, blindness, or who died or relocated were also excluded. OUTCOME MEASURES ABRs were performed at 35 week PMA using 80 dB nHL and I-V IPL (ms) measured. Auditory Comprehension (AC) and Expressive Communication (EC) were evaluated by a speech-language pathologist at 3 years of age using Preschool Language Scale. RESULTS Eighty infants were studied. The mean GA and birth weight of infants were 29.2 weeks and 1336 g, respectively. There was association of worse ear I-V IPL and better ear I-V IPL with AC (Coefficient-5.4, 95% CI: -9.8 to -0.9 and Coefficient-5.5, 95% CI: -10 to-0.9, respectively) and EC (Coefficient-5.6, 95% CI: -9.5 to-1.8 and Coefficient-6.7, 95% CI: -10.6 to-2.7, respectively) after controlling for confounders. CONCLUSION The neonatal I-V IPL is a predictor of language development at 3 years of age in preterms.
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Affiliation(s)
- Sanjiv B. Amin
- Department of Pediatrics, Division of Neonatology, The University of Rochester School of Medicine and Dentistry and Nazarath College
| | - Dawn Vogler-Elias
- Department of Otolaryngology and Department of Audiology, The University of Rochester School of Medicine and Dentistry and Nazarath College
| | - Mark Orlando
- Department of Otolaryngology and Department of Audiology, The University of Rochester School of Medicine and Dentistry and Nazarath College
| | - Hongyue Wang
- Department of Biostatistics, The University of Rochester School of Medicine and Dentistry and Nazarath College
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Pérez-Pereira M, Fernández P, Gómez-Taibo ML, Resches M. Language development of low risk preterm infants up to the age of 30 months. Early Hum Dev 2014; 90:649-56. [PMID: 25189697 DOI: 10.1016/j.earlhumdev.2014.08.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Revised: 08/08/2014] [Accepted: 08/12/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare the lexical and grammatical development of a group of low risk preterm children with a group of full-term children at 10, 22, and 30 months of corrected age. In addition, the effect of possible determinant factors on linguistic development was investigated. METHOD An initial group of 150 low-risk PR children (mean GA: 32.62) and 49 FT children (mean GA: 39.70) recruited at birth were assessed at 10, 22, and 30 months of age. Communicative and linguistic abilities were measured at these three points in time through the CDI. Cognitive development and quality of family environment of the children, among other variables, were also assessed at 22 months of age. Hierarchical regression analyses were performed in order to test those factors which may contribute to prediction of language outcomes. RESULTS There was no significant delay in communicative, lexical or grammatical development of PR children. Even when comparisons were performed between fullterm and very preterm children, differences were not significant. Regression analyses indicate that gestures and early word comprehension predict very early word production development, but their effect disappears with time. The most important factors which predict language development at 30 months of age are previous cognitive scores and word production at 22 months of age. The results coming from group comparisons and from hierarchical regression analyses indicate that GA does not significantly affect language development from 10 to 30 months of age. CONCLUSIONS Low risk preterm toddlers do not seem to be delayed in their linguistic development.
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Smith JM, DeThorne LS, Logan JAR, Channell RW, Petrill SA. Impact of prematurity on language skills at school age. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2014; 57:901-916. [PMID: 24167241 DOI: 10.1044/1092-4388(2013/12-0347)] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE The existing literature on language outcomes in children born prematurely focuses almost exclusively on standardized test scores rather than discourse-level abilities. The authors of this study looked longitudinally at school-age language outcomes and potential moderating variables for a group of twins born prematurely versus a control group of twins born at full term, analyzing both standardized test results and language sample data from the population-based Western Reserve Reading Project (WRRP; Petrill, Deater-Deckard, Thompson, DeThorne, & Schatschneider, 2006). METHOD Fifty-seven children born prematurely, at ≤32 weeks or <1,500 g, were compared with 57 children born at full term and were matched for age, gender, race, and parental education. Data included discourse-level language samples and standardized test results, collected at average ages 7, 8, and 10 years. The language samples were analyzed to yield a number of semantic and syntactic measures that were consolidated via factor analysis. RESULTS Regression models showed significant differences between the 2 groups for standardized test results, although the mean score for both groups fell in the normal range. For the discourse-level language measures, however, differences never reached statistical significance. Parental education was significantly associated with improved standardized test scores. CONCLUSIONS These findings suggest that in the absence of frank neurological impairment, sophisticated semantic and syntactic skills may be relatively intact in the discourse-level language of children born prematurely. Implications for assessment, particularly the potential role of attention and executive function in standardized testing tasks, are reviewed.
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Stolt S, Korja R, Matomäki J, Lapinleimu H, Haataja L, Lehtonen L. Early relations between language development and the quality of mother-child interaction in very-low-birth-weight children. Early Hum Dev 2014; 90:219-25. [PMID: 24636213 DOI: 10.1016/j.earlhumdev.2014.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 02/17/2014] [Accepted: 02/19/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND It is not clearly understood how the quality of early mother-child interaction influences language development in very-low-birth-weight children (VLBW). AIMS We aim to analyze associations between early language and the quality of mother-child interaction, and, the predictive value of the features of early mother-child interaction on language development at 24 months of corrected age in VLBW children. STUDY DESIGN A longitudinal prospective follow-up study design was used. METHODS The participants were 28 VLBW children and 34 full-term controls. Language development was measured using different methods at 6, 12 and at 24 months of age. The quality of mother-child interaction was assessed using PC-ERA method at 6 and at 12 months of age. RESULTS Associations between the features of early interaction and language development were different in the groups of VLBW and full-term children. There were no significant correlations between the features of mother-child interaction and language skills when measured at the same age in the VLBW group. Significant longitudinal correlations were detected in the VLBW group especially if the quality of early interactions was measured at six months and language skills at 2 years of age. However, when the predictive value of the features of early interactions for later poor language performance was analyzed separately, the features of early interaction predicted language skills in the VLBW group only weakly. CONCLUSIONS The biological factors may influence on the language development more in the VLBW children than in the full-term children. The results also underline the role of maternal and dyadic factors in early interactions.
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Affiliation(s)
- S Stolt
- Dept. of Behavioural Sciences and Philosophy, University of Turku, Turku, Finland.
| | - R Korja
- Dept. of Child Psychiatry, Turku University Hospital and University of Turku, Finland
| | - J Matomäki
- Dept. of Pediatrics, Turku University Hospital and University of Turku, Turku, Finland
| | - H Lapinleimu
- Dept. of Pediatrics, Turku University Hospital and University of Turku, Turku, Finland
| | - L Haataja
- Dept. of Pediatric Neurology, Turku University Hospital and University of Turku, Turku, Finland
| | - L Lehtonen
- Dept. of Pediatrics, Turku University Hospital and University of Turku, Turku, Finland
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23
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Lodha A, Sauvé R, Bhandari V, Tang S, Christianson H, Bhandari A, Amin H, Singhal N. Need for supplemental oxygen at discharge in infants with bronchopulmonary dysplasia is not associated with worse neurodevelopmental outcomes at 3 years corrected age. PLoS One 2014; 9:e90843. [PMID: 24646665 PMCID: PMC3960119 DOI: 10.1371/journal.pone.0090843] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 02/04/2014] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To determine if chronic oxygen dependency (discharge home on supplemental oxygen) in children with bronchopulmonary dysplasia (BPD; defined as requirement for supplemental O2 at 36 weeks postmenstrual age) predicts neurodevelopmental disability rates and growth outcomes at 36 months corrected age (CA). STUDY DESIGN Longitudinal cohort study. SETTING Southern Alberta regional center located at high altitude. PARTICIPANTS Preterm infants weighing ≤1250 grams with no BPD, BPD, and BPD with chronic oxygen dependency. MAIN OUTCOME MEASURES Neurodevelopmental and growth outcomes. RESULTS Of 1563 preterm infants admitted from 1995-2007, 1212 survived. Complete follow-up data were available for 1030 (85%) children. Children in BPD and BPD with chronic oxygen dependency groups had significantly lower birth weights, gestational ages, prolonged mechanical ventilation and oxygen supplementation and received more postnatal steroids, compared to those without BPD. Children with BPD and BPD with chronic oxygen dependency were more likely to be below the 5th centile in weight and height compared to those without BPD but there was little difference between the BPD and BPD with chronic oxygen dependency groups. After controlling for confounding variables, children who had BPD and BPD with chronic oxygen dependency had higher odds of neurodevelopmental disability compared to those without BPD [OR (odds ratio) 1.9 (95%CI 1.1 to 3.5) and OR 1.8 (1.1 to 2.9), respectively], with no significant difference between BPD and BPD with chronic oxygen dependency [OR 0.9 (95% CI 0.6 to 1.5)]. CONCLUSIONS BPD and BPD with chronic oxygen dependency in children predicts abnormal neurodevelopmental outcomes at 36 months CA. However, the neurodevelopmental disability rates were not significantly higher in BPD with chronic oxygen dependency children compared to children with BPD only. Compared to those without BPD, growth is impaired in children with BPD and BPD with chronic oxygen dependency, but no difference between the latter two groups.
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Affiliation(s)
- Abhay Lodha
- Department of Pediatrics, Foothills Medical Centre, Peter Lougheed Centre, Alberta Children’s Hospital, Calgary, Canada
- Community Health Sciences, University of Calgary, Calgary, Canada
- Alberta Health Services, Calgary, Canada
- Alberta Children’s Hospital Institute of Child & Maternal Health, Calgary, Canada
| | - Reg Sauvé
- Department of Pediatrics, Foothills Medical Centre, Peter Lougheed Centre, Alberta Children’s Hospital, Calgary, Canada
- Community Health Sciences, University of Calgary, Calgary, Canada
- Alberta Health Services, Calgary, Canada
- Alberta Children’s Hospital Institute of Child & Maternal Health, Calgary, Canada
| | - Vineet Bhandari
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | | | - Heather Christianson
- Community Health Sciences, University of Calgary, Calgary, Canada
- Alberta Health Services, Calgary, Canada
| | - Anita Bhandari
- Department of Pediatric Pulmonology, Connecticut Children’s Medical Center, Hartford, Connecticut, United States of America
| | - Harish Amin
- Department of Pediatrics, Foothills Medical Centre, Peter Lougheed Centre, Alberta Children’s Hospital, Calgary, Canada
- Alberta Health Services, Calgary, Canada
| | - Nalini Singhal
- Department of Pediatrics, Foothills Medical Centre, Peter Lougheed Centre, Alberta Children’s Hospital, Calgary, Canada
- Alberta Health Services, Calgary, Canada
- Alberta Children’s Hospital Institute of Child & Maternal Health, Calgary, Canada
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24
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Perez-Pereira M, Fernandez P, Gómez-Taibo M, Gonzalez L, Trisac JL, Casares J, Dominguez M. Neurobehavioral development of preterm and full term children: biomedical and environmental influences. Early Hum Dev 2013; 89:401-9. [PMID: 23312396 DOI: 10.1016/j.earlhumdev.2012.12.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 11/13/2012] [Accepted: 12/16/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Previous studies indicate that VLBW preterm children obtain significantly lower scores than full-term children in all the NBAS clusters. However the samples studied usually presented additional medical complications. AIMS The present study aims to compare the results obtained by low-risk preterm and full term children in the NBAS, and relate possible differences to biological and contextual factors. METHOD Early neurobehavioral development of 150 preterm (PR) children is compared to that of 49 full term children (FT). The children were assessed at the age of 15 days (corrected age for preterm children) with the NBAS. Biological and environmental variables were collected through an extended interview with the mothers as well as medical data. RESULTS Significant differences were found between preterm and full term children in the following areas: motor, range of state, and regulation of state. Differences were also found in relation to birth weight in these same three areas, following a parallel pattern. These differences between the two groups were not, however, necessarily more favorable for the FT group; the PR group had higher results in the motor and range of state areas, and lower results in the regulation of state area. The mothers' smoking habit had a negative effect on infants' regulation and orientation. CONCLUSIONS No general maturation delay in this particular sample of preterm children was found.
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Affiliation(s)
- M Perez-Pereira
- Department of Developmental Psychology, University of Santiago de Compostela, Spain.
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25
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Bronchopulmonary dysplasia: a review. Arch Gynecol Obstet 2013; 288:325-33. [DOI: 10.1007/s00404-013-2753-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 02/04/2013] [Indexed: 10/27/2022]
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van Noort-van der Spek IL, Franken MCJP, Weisglas-Kuperus N. Language functions in preterm-born children: a systematic review and meta-analysis. Pediatrics 2012; 129:745-54. [PMID: 22430458 DOI: 10.1542/peds.2011-1728] [Citation(s) in RCA: 197] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Preterm-born children (<37 weeks' gestation) have higher rates of language function problems compared with term-born children. It is unknown whether these problems decrease, deteriorate, or remain stable over time. The goal of this research was to determine the developmental course of language functions in preterm-born children from 3 to 12 years of age. METHODS Computerized databases Embase, PubMed, Web of Knowledge, and PsycInfo were searched for studies published between January 1995 and March 2011 reporting language functions in preterm-born children. Outcome measures were simple language function assessed by using the Peabody Picture Vocabulary Test and complex language function assessed by using the Clinical Evaluation of Language Fundamentals. Pooled effect sizes (in terms of Cohen's d) and 95% confidence intervals (CI) for simple and complex language functions were calculated by using random-effects models. Meta-regression was conducted with mean difference of effect size as the outcome variable and assessment age as the explanatory variable. RESULTS Preterm-born children scored significantly lower compared with term-born children on simple (d = -0.45 [95% CI: -0.59 to -0.30]; P < .001) and on complex (d = -0.62 [95% CI: -0.82 to -0.43]; P < .001) language function tests, even in the absence of major disabilities and independent of social economic status. For complex language function (but not for simple language function), group differences between preterm- and term-born children increased significantly from 3 to 12 years of age (slope = -0.05; P = .03). CONCLUSIONS While growing up, preterm-born children have increasing difficulties with complex language function.
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Affiliation(s)
- Inge L van Noort-van der Spek
- Department of Otorhinolaryngology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, Netherlands.
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Törölä H, Lehtihalmes M, Heikkinen H, Olsén P, Yliherva A. Early vocalization of preterm infants with extremely low birth weight (ELBW), Part II: From canonical babbling up to the appearance of the first word. CLINICAL LINGUISTICS & PHONETICS 2012; 26:345-356. [PMID: 22404864 DOI: 10.3109/02699206.2011.636500] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The aim of this study was to systematically describe the preverbal development of preterm infants from canonical babbling up to the first word and to compare it with that of healthy full-term infants. In addition, the amount of vocalization between the preterm and full-term groups was compared. The sample consisted of 18 preterm infants with extremely low birth weight and 11 full-term infants. The development of preverbal vocalization before variegated babbling did not differ between the groups. Instead, the preterm infants failed to produce more different kinds of canonical syllable types than the full-term infants. However, they showed a larger variance of variegated babbling skills and remained in the babbling phase longer before reaching the first meaningful word compared with the full-term infants. Following the onset of canonical babbling, the preterm infants produced fewer vocalizations than the full-term infants and they reached the first word later than the full-term infants.
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Affiliation(s)
- Helena Törölä
- Faculty of Humanities, Logopedics, Department of Mathematical Sciences/IT Administration Services, University of Oulu, and Department of Paediatrics and Adolescence, Oulu University Hospital, Oulu, Finland.
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Northam GB, Liégeois F, Chong WK, Baker K, Tournier JD, Wyatt JS, Baldeweg T, Morgan A. Speech and oromotor outcome in adolescents born preterm: relationship to motor tract integrity. J Pediatr 2012; 160:402-408.e1. [PMID: 22000302 PMCID: PMC3657185 DOI: 10.1016/j.jpeds.2011.08.055] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 05/31/2011] [Accepted: 08/25/2011] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To assess speech abilities in adolescents born preterm and investigate whether there is an association between specific speech deficits and brain abnormalities. STUDY DESIGN Fifty adolescents born prematurely (<33 weeks' gestation) with a spectrum of brain injuries were recruited (mean age, 16 years). Speech examination included tests of speech-sound processing and production and speech and oromotor control. Conventional magnetic resonance imaging and diffusion-weighted imaging was acquired in all adolescents born preterm and 30 term-born control subjects. Radiological ratings of brain injury were recorded and the integrity of the primary motor projections was measured (corticospinal tract and speech-motor corticobulbar tract [CST/CBT]). RESULTS There were no clinical diagnoses of developmental dysarthria, dyspraxia, or a speech-sound disorder, but difficulties in speech and oromotor control were common. A regression analysis revealed that presence of a neurologic impairment, and diffusion-weighted imaging abnormalities in the left CST/CBT were significant independent predictors of poor speech and oromotor outcome. These left-lateralized abnormalities were most evident at the level of the posterior limb of the internal capsule. CONCLUSION Difficulties in speech and oromotor control are common in adolescents born preterm, and adolescents with injury to the CST/CBT pathways in the left-hemisphere may be most at risk.
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Key Words
- cbt, corticobulbar tract
- cst, corticospinal tract
- cus, cranial ultrasound scanning
- dwi, diffusion-weighted imaging
- fa, fractional anisotropy
- foc, focal oromotor control
- fsiq, full-scale iq
- hpi, hemorrhagic parenchymal infarction
- ivh, intraventricular hemorrhage
- mri, magnetic resonance imaging
- plic, posterior limb of the internal capsule
- vmpac, verbal motor production assessment for children
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Affiliation(s)
- Gemma B. Northam
- UCL Institute of Child Health, London, United Kingdom,Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom,Reprint requests: Gemma B. Northam, MSc, Developmental Cognitive Neuroscience Unit, UCL Institute of Child Health, London, WC1N 1EH, United Kingdom.
| | - Frédérique Liégeois
- UCL Institute of Child Health, London, United Kingdom,Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - Wui K. Chong
- Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - Kate Baker
- UCL Institute of Child Health, London, United Kingdom
| | | | - John S. Wyatt
- UCL Institute for Women’s Health, London, United Kingdom
| | - Torsten Baldeweg
- UCL Institute of Child Health, London, United Kingdom,Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - Angela Morgan
- Murdoch Childrens Research Institute, Melbourne, Australia,Royal Children’s Hospital, Melbourne, Australia
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Onland W, Offringa M, Cools F, De Jaegere AP, Rademaker K, Blom H, Cavatorta E, Debeer A, Dijk PH, van Heijst AF, Kramer BW, Kroon AA, Mohns T, van Straaten HL, te Pas AB, Theyskens C, van Weissenbruch MM, van Kaam AH. Systemic Hydrocortisone To Prevent Bronchopulmonary Dysplasia in preterm infants (the SToP-BPD study); a multicenter randomized placebo controlled trial. BMC Pediatr 2011; 11:102. [PMID: 22070744 PMCID: PMC3245429 DOI: 10.1186/1471-2431-11-102] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 11/09/2011] [Indexed: 12/05/2022] Open
Abstract
Background Randomized controlled trials have shown that treatment of chronically ventilated preterm infants after the first week of life with dexamethasone reduces the incidence of the combined outcome death or bronchopulmonary dysplasia (BPD). However, there are concerns that dexamethasone may increase the risk of adverse neurodevelopmental outcome. Hydrocortisone has been suggested as an alternative therapy. So far no randomized controlled trial has investigated its efficacy when administered after the first week of life to ventilated preterm infants. Methods/Design The SToP-BPD trial is a randomized double blind placebo controlled multicenter study including 400 very low birth weight infants (gestational age < 30 weeks and/or birth weight < 1250 grams), who are ventilator dependent at a postnatal age of 7 - 14 days. Hydrocortisone (cumulative dose 72.5 mg/kg) or placebo is administered during a 22 day tapering schedule. Primary outcome measure is the combined outcome mortality or BPD at 36 weeks postmenstrual age. Secondary outcomes are short term effects on the pulmonary condition, adverse effects during hospitalization, and long-term neurodevelopmental sequelae assessed at 2 years corrected gestational age. Analysis will be on an intention to treat basis. Discussion This trial will determine the efficacy and safety of postnatal hydrocortisone administration at a moderately early postnatal onset compared to placebo for the reduction of the combined outcome mortality and BPD at 36 weeks postmenstrual age in ventilator dependent preterm infants. Trial registration number Netherlands Trial Register (NTR): NTR2768
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Affiliation(s)
- Wes Onland
- Department of Neonatology, Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands
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Stolt S, Lehtonen L, Haataja L, Lapinleimu H. El lenguaje utilizado por niños con muy bajo peso al nacer en la interacción temprana entre madre e hijo, con atención especial a la aparición de la gramática. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s0214-4603(11)70180-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Biological and environmental factors as predictors of language skills in very preterm children at 5 years of age. J Dev Behav Pediatr 2011; 32:239-49. [PMID: 21317804 DOI: 10.1097/dbp.0b013e31820b7882] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Language problems are thought to occur more frequently in very preterm children compared with healthy term born children. The primary aim of this study was to examine the contributions of biological and environmental risk factors to language outcomes in very preterm children at 5 years of age. METHODS A cohort of 227 very preterm infants (birth weight <1250 g or gestational age <30 weeks) were recruited at birth and followed up at 2 and 5 years of age (corrected for prematurity) in a prospective, longitudinal study in Melbourne, Australia. Outcomes at 5 years of age were the Expressive and Receptive Language Scales from the Kaufman Survey of Early Academic and Language Skills. A range of hypothesized biological and environmental factors identified from past research were examined as predictors of language outcomes at 5 years of age using linear regression models. RESULTS Lower maternal education and poorer communication skills in the child at 2 years of age were predictive of poorer expressive and poorer receptive language outcomes at 5 years of age. Lower expressive language scores were also associated with the presence of moderate-severe white matter abnormalities on neonatal magnetic resonance imaging. CONCLUSIONS Results support the role of both biological and environmental factors in the evolution of language difficulties and highlight the need to consider these factors in the follow-up of preterm infants.
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Bosch L. Precursors to language in preterm infants: speech perception abilities in the first year of life. PROGRESS IN BRAIN RESEARCH 2011; 189:239-57. [PMID: 21489393 DOI: 10.1016/b978-0-444-53884-0.00028-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Language development in infants born very preterm is often compromised. Poor language skills have been described in preschoolers and differences between preterms and full terms, relative to early vocabulary size and morphosyntactical complexity, have also been identified. However, very few data are available concerning early speech perception abilities and their predictive value for later language outcomes. An overview of the results obtained in a prospective study exploring the link between early speech perception abilities and lexical development in the second year of life in a population of very preterm infants (≤32 gestation weeks) is presented. Specifically, behavioral measures relative to (a) native-language recognition and discrimination from a rhythmically distant and a rhythmically close nonfamiliar languages, and (b) monosyllabic word-form segmentation, were obtained and compared to data from full-term infants. Expressive vocabulary at two test ages (12 and 18 months, corrected age for gestation) was measured using the MacArthur Communicative Development Inventory. Behavioral results indicated that differences between preterm and control groups were present, but only evident when task demands were high in terms of language processing, selective attention to relevant information and memory load. When responses could be based on acquired knowledge from accumulated linguistic experience, between-group differences were no longer observed. Critically, while preterm infants responded satisfactorily to the native-language recognition and discrimination tasks, they clearly differed from full-term infants in the more challenging activity of extracting and retaining word-form units from fluent speech, a fundamental ability for starting to building a lexicon. Correlations between results from the language discrimination tasks and expressive vocabulary measures could not be systematically established. However, attention time to novel words in the word segmentation task yielded a significant correlation with vocabulary at both test ages. The predictive value of the behavioral measures in this research for an early identification of language delays in the preterm population was, thus, limited. However, early evidence of preterms' difficulties in speech and language processing tasks involving complex materials reveals a weakness in their initial approach to the language acquisition process that may constrain their future language skills well beyond the prelexical stage.
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Affiliation(s)
- Laura Bosch
- Department of Basic Psychology, Faculty of Psychology, Institute for Research in Brain, Cognition and Behavior (IR3C), University of Barcelona, Barcelona, Spain.
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Nelson S, Albert JM, Lombardi G, Wishnek S, Asaad G, Kirchner HL, Singer LT. Dental caries and enamel defects in very low birth weight adolescents. Caries Res 2010; 44:509-18. [PMID: 20975268 PMCID: PMC2992634 DOI: 10.1159/000320160] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Accepted: 07/27/2010] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The purpose of this study was to examine developmental enamel defects and dental caries in very low birth weight adolescents with high risk (HR-VLBW) and low risk (LR-VLBW) compared to full-term (term) adolescents. METHODS The sample consisted of 224 subjects (80 HR-VLBW, 59 LR-VLBW, 85 term adolescents) recruited from an ongoing longitudinal study. Sociodemographic and medical information was available from birth. Dental examination of the adolescent at the 14-year visit included: enamel defects (opacity and hypoplasia); decayed, missing, filled teeth of incisors and molars (DMFT-IM) and of overall permanent teeth (DMFT); Simplified Oral Hygiene Index for debris/calculus on teeth, and sealant presence. A caregiver questionnaire completed simultaneously assessed dental behavior, access, insurance status and prevention factors. Hierarchical analysis utilized the zero-inflated negative binomial model and zero-inflated Poisson model. RESULTS The zero-inflated negative binomial model controlling for sociodemographic variables indicated that the LR-VLBW group had an estimated 75% increase (p < 0.05) in number of demarcated opacities in the incisors and first molar teeth compared to the term group. Hierarchical modeling indicated that demarcated opacities were a significant predictor of DMFT-IM after control for relevant covariates. The term adolescents had significantly increased DMFT-IM and DMFT scores compared to the LR-VLBW adolescents. CONCLUSION LR-VLBW was a significant risk factor for increased enamel defects in the permanent incisors and first molars. Term children had increased caries compared to the LR-VLBW group. The effect of birth group and enamel defects on caries has to be investigated longitudinally from birth.
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Affiliation(s)
- S Nelson
- Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio 44106-4905, USA.
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van Noort-van der Spek IL, Franken MCJP, Wieringa MH, Weisglas-Kuperus N. Phonological development in very-low-birthweight children: an exploratory study. Dev Med Child Neurol 2010; 52:541-6. [PMID: 19832884 DOI: 10.1111/j.1469-8749.2009.03507.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Very-low-birthweight (VLBW; birthweight<1500 g and/or gestational age <32 wks) children are at risk for speech problems. However, there are few studies on speech development in VLBW children at an early age. The aim of this study was to investigate phonological development in 2-year-old VLBW children. METHOD Twenty VLBW children without major neurosensory impairment (7 males, 13 females; mean birthweight 971 g, SD 315; mean gestational age 28 wks, SD 1.81) and 20 term children (7 males, 13 females; mean birthweight 3503 g, SD 416; mean gestational age 40 wks, SD 1.26) were compared on measures of phonological development derived from 20-minute spontaneous speech samples of standardized mother-child play interaction as well as on standardized tests of cognitive and psychomotor development, language, and behaviour. RESULTS VLBW children had significantly fewer acquired consonants (median 9, p=0.02) and a significantly lower phonological mean length of utterance (pMLU; median 4.1, p<0.01) than term children (median acquired consonants 10, median pMLU 5.0). INTERPRETATION This study provides evidence for poor phonological development in even healthy VLBW children, compared with term-matched children, independent of their cognitive, psychomotor, and language development, and their behavioural functioning.
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Zanchetta S, Resende LADL, Bentlin MR, Rugulo LM, Trindade CEP. Conductive hearing loss in children with bronchopulmonary dysplasia: a longitudinal follow-up study in children aged between 6 and 24 months. Early Hum Dev 2010; 86:385-9. [PMID: 20554131 DOI: 10.1016/j.earlhumdev.2010.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2009] [Revised: 05/04/2010] [Accepted: 05/05/2010] [Indexed: 10/19/2022]
Abstract
AIMS To determine the occurrence of isolated and recurrent episodes of conductive hearing loss (CHL) during the first two years of life in very low birth weight (VLBW) infants with and without bronchopulmonary dysplasia (BPD). STUDY DESIGN, SUBJECTS AND OUTCOME MEASURES: In a longitudinal clinical study, 187 children were evaluated at 6, 9, 12, 15 18 and 24 months of age by visual reinforcement audiometry, tympanometry and auditory brain response system. RESULTS Of the children with BPD, 54.5% presented with episodes of CHL, as opposed to 34.7% of the children without BPD. This difference was found to be statistically significant. The recurrent or persistent episodes were more frequent among children with BPD (25.7%) than among those without BPD (8.3%). The independent variables that contributed to this finding were small for gestational age and a 5 min Apgar score. CONCLUSIONS Recurrent CHL episodes are more frequent among VLBW infants with BPD than among VLBW infants without BPD.
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Affiliation(s)
- Sthella Zanchetta
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto-University of São Paulo, Ribeirão Preto, SP, Brazil.
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Abstract
As more very preterm infants survive, more survivors will have bronchopulmonary dysplasia (BPD). Children with BPD have higher rates of cognitive, educational and behavioural impairments, and also reduced lung function, through childhood and into early life than would normally be expected. The importance of these neurological and respiratory problems later into adult life needs to be determined.
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Affiliation(s)
- Lex W Doyle
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
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McGowan EC, Kostadinov S, McLean K, Gotsch F, Venturini D, Romero R, Laptook AR, Sharma S. Placental IL-10 dysregulation and association with bronchopulmonary dysplasia risk. Pediatr Res 2009; 66:455-60. [PMID: 19581835 PMCID: PMC2795791 DOI: 10.1203/pdr.0b013e3181b3b0fa] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cytokine profiles in amniotic fluid, cord serum, and tracheal aspirate of premature infants suggest a shift toward a proinflammatory state. Cytokines also contribute to the pathogenesis of bronchopulmonary dysplasia (BPD). We hypothesize that the initiating events for BPD are reflected in the placenta and propose that placental expression of cytokines provide a blueprint of events leading to BPD. This is a retrospective, case-controlled study of placental cytokines of premature infants with (n = 49) and without (n = 49) BPD, matched for gender, birth weight, and year of birth at Women and Infants Hospital between 2003 and 2005. Cytokine expression, including IL-6 and IL-10, was determined by immunohistochemistry in membrane rolls, umbilical cords, and placentas. IL-6 was similarly expressed in all tissues of infants with and without BPD. In contrast, anti-inflammatory cytokine IL-10 was less prominent in the placenta of patients with BPD compared with those without BPD. IL-10 expression in the villous trophoblast layer was associated with a reduced odds ratio of developing BPD (adjusted OR 0.08, 95% CI 0.01-0.70, p = 0.02). These results suggest that a placental balance between inflammatory and anti-inflammatory cytokines is crucial to normal lung organogenesis. Importantly, IL-10 seems to be protective against the development of BPD.
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Affiliation(s)
- Elisabeth C McGowan
- Department of Pediatrics, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island 02915, USA
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Laughon M, O'Shea MT, Allred EN, Bose C, Kuban K, Van Marter LJ, Ehrenkranz RA, Leviton A. Chronic lung disease and developmental delay at 2 years of age in children born before 28 weeks' gestation. Pediatrics 2009; 124:637-48. [PMID: 19620203 PMCID: PMC2799188 DOI: 10.1542/peds.2008-2874] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Extremely low gestational age newborns (ELGANs) are at increased risk of chronic lung disease (CLD) and of developmental delay. Some studies have suggested that CLD contributes to developmental delay. PATIENTS AND METHODS We examined data collected prospectively on 915 infants born before the 28th week of gestation in 2002-2004 who were assessed at 24 months of age with the Bayley Scales of Infant Development-2nd Edition or the Vineland Adaptive Behavior Scales. We excluded infants who were not able to walk independently (Gross Motor Function Classification System score < 1) and, therefore, more likely to have functionally important fine motor impairments. We defined CLD as receipt of oxygen at 36 weeks' postmenstrual age and classified infants as either not receiving mechanical ventilation (MV) (CLD without MV) or receiving MV (CLD with MV). RESULTS Forty-nine percent of ELGANs had CLD; of these, 14% were receiving MV at 36 weeks' postmenstrual age. ELGANs without CLD had the lowest risk of a Mental Developmental Index (MDI) or a Psychomotor Developmental Index (PDI) of <55, followed by ELGANs with CLD not receiving MV, and ELGANs with CLD receiving MV (9%, 12%, and 18% for the MDI and 7%, 10%, and 20% for the PDI, respectively). In time-oriented multivariate models, the risk of an MDI of <55 was associated with the following variables: gestational age of <25 weeks; single mother; late bacteremia; pneumothorax; and necrotizing enterocolitis. The risk of a PDI of <55 was associated with variables such as single mother, a complete course of antenatal corticosteroids, early and persistent pulmonary dysfunction, pulmonary deterioration during the second postnatal week, pneumothorax, and pulmonary interstitial emphysema. CLD, without or with MV, was not associated with the risk of either a low MDI or a low PDI. However, CLD with MV approached, but did not achieve, nominal statistical significance (odds ratio: 1.9 [95% confidence interval: 0.97-3.9]) for the association with a PDI of <55. CONCLUSIONS Among children without severe gross motor delays, risk factors for CLD account for the association between CLD and developmental delay. Once those factors are considered in time-oriented risk models, CLD does not seem to increase the risk of either a low MDI or a low PDI. However, severe CLD might increase the risk of a low PDI.
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Affiliation(s)
- Matthew Laughon
- Division of Neonatal-Perinatal Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina 27599-7596, USA.
| | - Michael T. O'Shea
- Division of Neonatology, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Elizabeth N. Allred
- Department of Neurology, Harvard Medical School, Boston, Massachusetts,Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts,Department of Neurology, Children's Hospital Boston, Boston, Massachusetts
| | - Carl Bose
- Division of Neonatal-Perinatal Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Karl Kuban
- Division of Pediatric Neurology, Boston Medical Center, Boston, Massachusetts
| | - Linda J. Van Marter
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts,Division of Newborn Medicine, Children's Hospital Boston, Boston, Massachusetts,Division of Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Richard A. Ehrenkranz
- Division of Perinatal Medicine, School of Medicine, Yale University, New Haven, Connecticut
| | - Alan Leviton
- Department of Neurology, Harvard Medical School, Boston, Massachusetts,Department of Neurology, Children's Hospital Boston, Boston, Massachusetts
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Abstract
Bronchopulmonary dysplasia is a chronic lung disease associated with premature birth and characterized by early lung injury. In this review we discuss some pitfalls, problems, and progress in this condition over the last decade, focusing mainly on the last 5 years, limited to studies in human neonates. Changes in the definition, pathogenesis, genetic susceptibility, and recent biomarkers associated with bronchopulmonary dysplasia will be discussed. Progress in current management strategies, along with novel approaches/therapies, will be critically appraised. Finally, recent data on long-term pulmonary and neurodevelopmental outcomes of infants with bronchopulmonary dysplasia will be summarized.
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Affiliation(s)
- Anita Bhandari
- Division of Pediatric Pulmonology, Connecticut Children's Medical Center, Hartford, Connecticut, USA
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Miller RJ, Sullivan MC, Hawes K, Marks AK. The effects of perinatal morbidity and environmental factors on health status of preterm children at age 12. J Pediatr Nurs 2009; 24:101-14. [PMID: 19268232 PMCID: PMC2742999 DOI: 10.1016/j.pedn.2008.02.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2007] [Revised: 02/22/2008] [Accepted: 02/23/2008] [Indexed: 11/20/2022]
Abstract
Children born prematurely have later morbidity, yet little is known about their health in adolescence. This study examined multiple dimensions of health at age 12 and the predictors of biological, behavioral, social, and physical environmental factors. Analysis of variance and logistic regression models were tested. Perinatal morbidity predicted health at age 12. Preterm status increases the risk of later alterations in health. Bronchopulmonary dysplasia, necrotizing enterocolitis, intraventricular hemorrhage, small-for-gestational age, parental perception of child health, and parental psychological distress affect later health. Prematurity and perinatal morbidity continue to impact child health 12 years after birth.
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O'Shea TM, Nageswaran S, Hiatt DC, Legault C, Moore ML, Naughton M, Goldstein DJ, Dillard RG. Follow-up care for infants with chronic lung disease: a randomized comparison of community- and center-based models. Pediatrics 2007; 119:e947-57. [PMID: 17387168 DOI: 10.1542/peds.2006-1717] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Premature infants with chronic lung disease benefit from comprehensive care, which typically is based in tertiary medical centers. When such centers are not easily accessible, alternative models of care are needed. The purpose of this work was to compare community-based follow-up, provided via telephone contacts, to traditional center-based follow-up of premature infants with chronic lung disease. PATIENTS AND METHODS After discharge from neonatal intensive care, 150 premature infants with chronic lung disease were randomly assigned to either community-based (n = 75) or center-based (n = 75) follow-up. In community-based follow-up, a nurse specialist maintained telephone contact with the infant's primary caregiver and health care providers. Center-based follow-up consisted of visits to a medical center-based multidisciplinary clinic staffed by a neonatologist, a nurse specialist, and a social worker. The outcomes of interest were Bayley Scales of Infant Development mental developmental index and psychomotor developmental index, Vineland Adaptive Behavioral Composite, and growth delay (weight for length <5th percentile) at 1-year adjusted age and respiratory rehospitalizations through 1-year adjusted age. RESULTS In each randomization group, 73 infants survived, and 69 were evaluated at 1-year adjusted age. The median mental development index (corrected for gestational age) was 90 for both groups. The median psychomotor developmental index was 82 for the center-based group and 81 for the community-based group. The median Vineland Adaptive Behavioral Composite was 100 and 102 for the center-based and community-based groups, respectively. In the center-based and community-based groups, respectively, the proportions with growth delay were 13% and 26%, and the proportions rehospitalized for respiratory illness were 33% and 29%. CONCLUSIONS Infants randomly assigned to community-based, as compared with those randomly assigned to center-based follow-up, had similar developmental and health outcomes. The former approach might be a preferred alternative for families in rural settings or families for whom access to a tertiary care medical center is difficult.
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Affiliation(s)
- T Michael O'Shea
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
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Abstract
Bronchopulmonary dysplasia (BPD) is a chronic lung disease associated with premature birth and characterized by early lung injury. Over the past 4 decades, there have been significant changes in its definition, pathology and radiological findings as well as management of BPD. Management of the acute phase and later stages of this lung disease continue to evolve. Use of non-invasive ventilatory techniques, recombinant human SOD and CC10 and inhaled NO are some novel approaches that are being studied. Adequate nutrition is vital to optimize lung growth and repair. The widely accepted practice of prophylaxis against viral infections has markedly decreased the rates of rehospitalization. Infants with BPD, however, continue to have significant pulmonary and neurodevelopmental sequelae. Unraveling the genetic contribution to BPD will potentially pave the way to improved preventive and therapeutic approaches.
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Affiliation(s)
- Anita Bhandari
- Division of Pediatric Pulmonology, Connecticut Children's Medical Center, Hartford, CT, USA
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Schirmer CR, Portuguez MW, Nunes ML. Clinical assessment of language development in children at age 3 years that were born preterm. ARQUIVOS DE NEURO-PSIQUIATRIA 2006; 64:926-31. [PMID: 17220997 DOI: 10.1590/s0004-282x2006000600007] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2006] [Accepted: 08/10/2006] [Indexed: 01/18/2023]
Abstract
OBJECTIVE: To evaluate the influence of gestational age and birth weight on language development and neurodevelopmental outcome at age 3 years in children born preterm. METHOD: Cross sectional study including 69 children followed in our developmental outpatient clinic. Patients were consecutively included at the time of the 3 years of age appointment and stratified for birth weight (<1500 grams and between 1500-2500 grams). All patients were assessed for receptive and expressive language , Denver II and Bayley II tests and clinical neurological examination. For analysis patients were divided in two groups normal language acquisition (NLA) and delay in language acquisition (DLA). RESULTS: NLA children had higher scores on mental and psychomotor (p=<0.01, p=0.012) indexes of Bayley II. Newborns with less than 1500 grams had lower scores on all Bayley scale at age 36 months (p=0.002, p=0.007 and p<0.001). Multivariate analysis suggests an association between gestational age (p=0.032), abnormal behavior (p<0.001) and delay in language acquisition. Denver test at 12 and 24 months of age was a good predictor of delayed receptive and expressive language at three years of age (p=<0.01 and p=<0.01). CONCLUSION: Children born prematurely with low birth weight had an increased risk of language acquisition delay, and those had also lower cognitive and behavior scores when compared to NLA.
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Affiliation(s)
- Carolina Rizzotto Schirmer
- Developmental Outpatient Clinic HSL - PUCRS, Division of Neurology - Hospital São Lucas and School of Medicine Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) Porto Alegre RS - Brazil
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Raman L, Georgieff MK, Rao R. The role of chronic hypoxia in the development of neurocognitive abnormalities in preterm infants with bronchopulmonary dysplasia. Dev Sci 2006; 9:359-67. [PMID: 16764609 DOI: 10.1111/j.1467-7687.2006.00500.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Bronchopulmonary dysplasia is the most common pulmonary morbidity in preterm infants and is associated with chronic hypoxia. Animal studies have demonstrated structural, neurochemical and functional alterations due to chronic hypoxia in the developing brain. Long-term impairments in visual-motor, gross and fine motor, articulation, reading, mathematics, spatial memory and attention skills are prevalent in survivors of bronchopulmonary dysplasia, and impairments appear to correlate with the severity of hypoxia. However, due to the simultaneous occurrence of multiple neurodevelopmental risk factors, a primary or potentiating role for chronic hypoxia in these impairments has yet to be conclusively established.
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Affiliation(s)
- Lakshmi Raman
- Department of Pediatrics, Hennepin County Medical Center, Minneapolis, MN, USA
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45
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Abstract
Children born very preterm are vulnerable for long-term cognitive, educational, and behavioral impairments; bronchopulmonary dysplasia (BPD) is an additional risk factor which exacerbates these problems. As a population, children with BPD exhibit low average IQ, academic difficulties, delayed speech and language development, visual-motor integration impairments, and behavior problems. Neuropsychological studies are sparse, but there is some evidence that children with BPD also display attention problems, memory and learning deficits, and executive dysfunction. BPD does not appear to be associated with a specific neuropsychological impairment but rather a global impairment.
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Sisk EA, Kim TB, Schumacher R, Dechert R, Driver L, Ramsey AM, Lesperance MM. Tracheotomy in very low birth weight neonates: indications and outcomes. Laryngoscope 2006; 116:928-33. [PMID: 16735883 DOI: 10.1097/01.mlg.0000214897.08822.14] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE/HYPOTHESIS To review incidence of, indications for, and outcomes of tracheotomy in very low birth weight (VLBW) infants. STUDY DESIGN Retrospective review in tertiary care hospital. METHODS Eighteen VLBW (<1,500 g) infants with bronchopulmonary dysplasia undergoing tracheotomy in the neonatal intensive care unit between October 1997 and June 2002 were studied. Controls consisted of 36 VLBW infants undergoing intubation without tracheotomy, two per study infant, matched by gestational age and weight. Outcome measures included duration and number of intubation events, time to decannulation, complications, comorbidities, length of stay, and speech, language, and swallowing measures. RESULTS Infants undergoing tracheotomy had an average duration of intubation of 128.8 days with a median number of 11.5 intubation events, both significantly greater than those of controls. Percentage of those with laryngotracheal stenosis was 44% of study infants had laryngotracheal stenosis compared to 1.6% in all intubated VLBW infants. The tracheotomy group had a significantly higher incidence of gastroesophageal reflux, pulmonary hypertension, and gastrostomy tube placement. The overall tracheotomy-related complication rate was 38.9%. Three were lost to follow-up, and five deaths occurred, two possibly tracheotomy-related. Six of ten were decannulated by an average time of 3.8 years, two of six after laryngotracheal reconstruction. Four of ten remained cannulated for a variety of reasons. Disorders of speech, language, and swallowing were common. CONCLUSIONS When considering tracheotomy in VLBW infants, the total number of intubation events should be monitored as well as the total duration of intubation. The relatively high incidence of laryngotracheal stenosis argues for earlier endoscopy and possibly earlier tracheotomy in infants with developing stenoses.
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Affiliation(s)
- Elizabeth A Sisk
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan 48109-0241, USA
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Abstract
Bronchopulmonary dysplasia is a chronic lung disease that affects premature babies and contributes to their morbidity and mortality. Improved survival of very immature infants has led to increased numbers of infants with this disorder. This increase puts a heavy burden on health resources since these infants need frequent re-admission to hospital in the first 2 years after birth and, even as adolescents, have lung-function abnormalities and persistent respiratory symptoms. Unlike the original description of the disease in 1967, premature infants can develop chronic oxygen dependency without severe, acute respiratory distress; this "new bronchopulmonary dysplasia" could be the result of impaired postnatal lung growth. Whether such infants subsequently have catch-up lung growth, especially if given corticosteroids postnatally, is unknown. No safe and effective preventive therapy has been identified, but promising new treatments directed either at reducing lung injury or improving lung growth are under study.
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Affiliation(s)
- John P Kinsella
- Department of Paediatrics, University of Colorado School of Medicine, Denver, USA.
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Rvachew S, Creighton D, Feldman N, Sauve R. Vocal development of infants with very low birth weight. CLINICAL LINGUISTICS & PHONETICS 2005; 19:275-94. [PMID: 16019776 DOI: 10.1080/02699200410001703457] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This study describes the vocal development of infants born with very low birth weights (VLBW). Samples of vocalizations were recorded from three groups of infants when they were 8, 12 and 18 months of age: preterm VLBW infants with bronchopulmonary dysplasia (BPD), preterm VLBW infants without BPD, and healthy full-term infants. Infants with BPD produced significantly smaller canonical syllable ratios than the full-term infants throughout the period of study. Premature VLBW infants who did not suffer from BPD produced relatively little canonical babble at 8 months of age, but were performing within the range of the full-term infants at 18 months of age. At 18 months of age, the infants with BPD were reported to have significantly smaller expressive vocabulary sizes than the healthier preterm and full-term infants.
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Affiliation(s)
- Susan Rvachew
- School of Communication Sciences and Disorders, McGill University, Montréal, Québec, Canada.
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Lee L, Stemple JC, Glaze L, Kelchner LN. Quick Screen for Voice and Supplementary Documents for Identifying Pediatric Voice Disorders. Lang Speech Hear Serv Sch 2004. [DOI: 10.1044/0161-1461(2004/030] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Three documents are provided to help the speech-language pathologist (SLP) identify children with voice disorders and educate family members. The first is a quickly administered screening test that covers multiple aspects of voice, respiration, and resonance. It was tested on 3,000 children in kindergarten and first and fifth grades, and on 47 preschoolers. The second document is a checklist of functional indicators of voice disorders that could be given to parents, teachers, or other caregivers to increase their attention to potential causes of voice problems and to provide the SLP with information pertinent to identification. The final document is a brochure with basic information about voice disorders and the need for medical examination. It may be used to help the SLP educate parents, particularly about the need for laryngeal examination for children who have been identified as having a voice problem.
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Affiliation(s)
- Linda Lee
- University of Cincinnati, OH
- University of Cincinnati, Department of Communication Sciences and Disorders, 202 Goodman Avenue, French East Building G-65, Cincinnati, OH 45267-0394
| | - Joseph C. Stemple
- Blaine Block Institute for Voice Analysis and Rehabilitation, Dayton, OH
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Short EJ, Klein NK, Lewis BA, Fulton S, Eisengart S, Kercsmar C, Baley J, Singer LT. Cognitive and academic consequences of bronchopulmonary dysplasia and very low birth weight: 8-year-old outcomes. Pediatrics 2003; 112:e359. [PMID: 14595077 DOI: 10.1542/peds.112.5.e359] [Citation(s) in RCA: 270] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine the effects of bronchopulmonary dysplasia (BPD) and very low birth weight (VLBW) on the cognitive and academic achievement of a large sample of 8-year-old children. METHODS Infants who were VLBW and had BPD (n = 98) or did not have BPD (n = 75) and term infants (n = 99) were followed prospectively to age 8. Groups were compared on measures assessing 4 broad areas of functioning: intelligence, achievement, gross motor, and attentional skills. Measures included the Wechsler Intelligence Scale for Children III, the Woodcock Johnson Test of Achievement-Revised, the Bruininks-Oseretsky Test of Motor Proficiency, the Tactual Performance Test (spatial memory), and the Continuous Performance Test (attention). School outcomes were assessed by parent and teacher report, as well as from school records. Groups were comparable on socioeconomic status, sex, and race. The total sample of BPD, VLBW, and term children was compared on all outcome measures. In addition, neurologic risk was assessed in the present sample and included the following: intraventricular hemorrhage, echodense lesions, porencephaly, hydrocephalus, ventriculoperitoneal shunt, meningitis, and periventricular leukomalacia. Individual difference analyses were conducted for neurologically intact children in all 3 groups. Finally, treatment effects were examined by comparing BPD children who had received steroids as part of their treatment with BPD children who had not. RESULTS The BPD group demonstrated deficits compared with VLBW and term children in intelligence; reading, mathematics, and gross motor skills; and special education services. VLBW children differed from term children in all of the above areas, except reading recognition, comprehension, and occupational therapy. Attentional differences were obtained between BPD and term children only. The BPD group (54%) was more likely to be enrolled in special education classes than VLBW (37%) or term children (25%). In addition, more BPD children (20%) achieved full-scale IQ scores <70, in the mental retardation range, compared with either VLBW (11%) or term (3%) children, with all VLBW children significantly more likely than term children to achieve IQs in the subaverage category. After controlling for birth weight and neurologic problems, BPD and/or duration on oxygen predicted lower performance IQ, perceptual organization, full-scale IQ, motor and attentional skills, and special education placement. The qualitative classification of BPD (present or absent) was a significant predictor for lower scores on measures of applied problems; motor skills; and incidence of speech-language, occupational, and physical therapies. Individual difference analyses were performed to ascertain whether differences between the risk groups were primarily attributable to neurologic complications. Even with the neurologically intact sample of BPD and VLBW children, differences between the term comparison group and both the BPD and VLBW groups were found for many outcome measures. When birth weight and neurologic complications were controlled, BPD and severity of BPD were associated with lower performance and full-scale IQ, poorer perceptual organization, attention, and motor skills, as well as lower school achievement and greater participation in special education, including occupational, physical, and speech-language therapies. Treatment protocol may in part be responsible for differences observed in our BPD sample. Steroid and nonsteroid groups of BPD children differed significantly in performance IQ (72.8 vs 84.8) and full-scale IQ (77.0 vs 85.2); perceptual organization (74.0 vs 85.2); Bruininks-Oseretsky Test of Motor Proficiency score (36.6 vs 44.7); and participation in special education (78% vs 48%), occupational therapy (71% vs 44%), and physical therapy (71% vs 41%). In every instance, BPD children who received steroids fared more poorly than BPD children who did not receive steroids. CONCLUSIONS BPD and duration on oxygen have long-term adverse effects on cognitive and academic achievement above and be beyond the effects of VLBW. The problems that have been identified at 8 years of age highlight the need for continued monitoring of the learning, behavior, and development of BPD children to intervene with children who are at risk for school problems.
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Affiliation(s)
- Elizabeth J Short
- Department of Psychology, Case Western Reserve University, Cleveland, OH 44106, USA.
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