1
|
Fraiman YS, Guyol G, Acevedo-Garcia D, Beck AF, Burris H, Coker TR, Tiemeier H. A Narrative Review of the Association between Prematurity and Attention-Deficit/Hyperactivity Disorder and Accompanying Inequities across the Life-Course. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1637. [PMID: 37892300 PMCID: PMC10605109 DOI: 10.3390/children10101637] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023]
Abstract
Preterm birth is associated with an increased risk of neurodevelopmental and neurobehavioral impairments including attention-deficit/hyperactivity disorder (ADHD), the most common neurobehavioral disorder of childhood. In this narrative review, we examine the known associations between prematurity and ADHD and highlight the impact of both prematurity and ADHD on multiple domains across the pediatric life-course. We develop a framework for understanding the health services journey of individuals with ADHD to access appropriate services and treatments for ADHD, the "ADHD Care Cascade". We then discuss the many racial and ethnic inequities that affect the risk of preterm birth as well as the steps along the "ADHD Care Cascade". By using a life-course approach, we highlight the ways in which inequities are layered over time to magnify the neurodevelopmental impact of preterm birth on the most vulnerable children across the life-course.
Collapse
Affiliation(s)
- Yarden S. Fraiman
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Genevieve Guyol
- Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02218, USA
| | - Dolores Acevedo-Garcia
- Heller School of Social Policy and Management, Brandeis University, Waltham, MA 02453, USA
| | - Andrew F. Beck
- Cincinnati Children’s, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Heather Burris
- Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tumaini R. Coker
- Seattle Children’s, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Henning Tiemeier
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| |
Collapse
|
2
|
Campos-Martorell A, Montaner Ramon A, Narváez Barros K, Marin Soria JL, López Galera RM, Fernández DY, León MC. Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational Age: Evaluation and Follow-up. J Clin Res Pediatr Endocrinol 2022; 14:453-462. [PMID: 35860376 PMCID: PMC9724057 DOI: 10.4274/jcrpe.galenos.2022.2022-2-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Preterm and low birth weight (LBW) neonates may present with thyroid dysfunction during a critical period for neurodevelopment. These alterations can be missed on routine congenital hypothyroidism (CH) screening which only measures thyroid stimulating hormone (TSH). The objective of this study was to evaluate a protocol for thyroid function screening (TFS) six years after national implementation. METHODS Serum TSH and free thyroxine (fT4) were measured during the second week of life in neonates below 31 weeks. Patients with abnormal TFS (fT4 <0.8 ng/dL and/or TSH >5 mU/L) were followed up with repeated tests until normal levels were reported. Patients who were still on levothyroxine (LT4) at three years of age were re-evaluated. RESULTS Five-hundred and nine neonates were included. Thyroid dysfunction was detected in 170 neonates (33%); CH n=20 (3.9%) including typical CH n=1; delayed TSH elevation CH n=19; hypothyroxinemia of prematurity (HOP) n=15 (2.9%); and transient hyperthyrotropinemia n=135 (26.5%). Twenty-one neonates (4.1%) were treated (20 for CH and 1 for HOP). At 3-year follow-up only three patients were diagnosed with permanent CH and still need treatment. LBW infants tended to have TSH levels higher than those with adequate weight. CONCLUSION This protocol was able to detect thyroid dysfunction in preterm neonates who were not identified by the current program based on TSH determination in whole-blood. This thyroid dysfunction seems to resolve spontaneously in a few months in the great majority of neonates, but in some cases LT4 could be needed. There is a critical need for specific guidelines regarding the follow-up and re-evaluation of transient CH in preterm neonates.
Collapse
Affiliation(s)
- Ariadna Campos-Martorell
- Autonomous University of Barcelona, Vall d’Hebron University Hospital, Clinic of Pediatric Endocrinology, Barcelona, Spain,* Address for Correspondence: Autonomous University of Barcelona, Vall d’Hebron University Hospital, Clinic of Pediatric Endocrinology, Barcelona, Spain E-mail:
| | | | | | - Jose Luis Marin Soria
- University of Barcelona, Spain School of Medicine, Neonatal Screening Program of Catalonia, Inborn Errors Metabolism Unit Biochemistry and Molecular Genetics Department Center for Biomedical Diagnosis (CDB) Hospital Clinic, Barcelona, Spain
| | - Rosa Maria López Galera
- University of Barcelona, Spain School of Medicine, Neonatal Screening Program of Catalonia, Inborn Errors Metabolism Unit Biochemistry and Molecular Genetics Department Center for Biomedical Diagnosis (CDB) Hospital Clinic, Barcelona, Spain
| | - Diego Yeste Fernández
- Autonomous University of Barcelona, Vall d’Hebron University Hospital, Clinic of Pediatric Endocrinology; Vall d’Hebron Research Institute, Clinic of Paediatric Endocrinology, Barcelona, Spain
| | - María Clemente León
- Autonomous University of Barcelona, Vall d’Hebron University Hospital, Clinic of Pediatric Endocrinology; Vall d’Hebron Research Institute, Clinic of Paediatric Endocrinology, Barcelona, Spain
| |
Collapse
|
3
|
Louis D, Oberoi S, Ricci MF, Pylypjuk C, Alvaro R, Seshia M, de Cabo C, Moddemann D, Lix LM, Garland A, Ruth CA. School Readiness Among Children Born Preterm in Manitoba, Canada. JAMA Pediatr 2022; 176:1010-1019. [PMID: 35939291 PMCID: PMC9361185 DOI: 10.1001/jamapediatrics.2022.2758] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 04/17/2022] [Indexed: 11/14/2022]
Abstract
Importance Children born preterm may experience learning challenges at school. However, there is a paucity of data on the school readiness of these children as they prepare to begin grade 1. Objective To examine the association between prematurity and school readiness in a population-based cohort of children. Design, Setting, and Participants This cohort study was conducted in the province of Manitoba, Canada, and involved 2 cohorts of children in kindergarten at the time of data collection. The population-based cohort included children born between January 1, 2000, and December 31, 2011, whose school readiness was assessed in kindergarten using the Early Development Instrument (EDI) data. The sibling cohort comprised children born preterm and their closest-in-age siblings born full term. Data were analyzed between March 12 and September 28, 2021. Exposures Preterm birth, defined as gestational age (GA) less than 37 weeks. Main Outcomes and Measures The primary outcome was vulnerability in the EDI, defined as a score below the tenth percentile of the Canadian population norms for any 1 or more of the 5 EDI domains (physical health and well-being, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge). Logistic regression models were used to identify the factors associated with vulnerability in the EDI. P values were adjusted for multiplicity using the Simes false discovery method. Results Of 86 829 eligible children, 63 277 were included, of whom 4352 were preterm (mean [SD] GA, 34 [2] weeks; 2315 boys [53%]) and 58 925 were full term (mean [SD] GA, 39 (1) weeks; 29 885 boys [51%]). Overall, 35% of children (1536 of 4352) born preterm were vulnerable in the EDI compared with 28% of children (16 449 of 58 925) born full term (adjusted odds ratio [AOR], 1.32; 95% CI, 1.23-1.41; P < .001]). Compared with children born full term, those born preterm had a higher percentage of vulnerability in each of the 5 EDI domains. In the population-based cohort, prematurity (34-36 weeks' GA: AOR, 1.23 [95% CI, 1.14-1.33]; <34 weeks' GA: AOR, 1.72 [95% CI, 1.48-1.99]), male sex (AOR, 2.24; 95% CI, 2.16-2.33), small for gestational age (AOR, 1.31; 95% CI, 1.23-1.40), and various maternal medical and sociodemographic factors were associated with EDI vulnerability. In the sibling cohort, EDI outcomes were similar for both children born preterm and their siblings born full term except for the communication skills and general knowledge domain (AOR, 1.39; 95% CI, 1.07-1.80) and Multiple Challenge Index (AOR, 1.43; 95% CI, 1.06-1.92), whereas male sex (AOR, 2.19; 95% CI, 1.62-2.96) and maternal age at delivery (AOR, 1.53; 95% CI, 1.38-1.70) were associated with EDI vulnerability. Conclusions and Relevance Results of this study suggest that, in a population-based cohort, children born preterm had a lower school-readiness rate than children born full term, but this difference was not observed in the sibling cohort. Child and maternal factors were associated with lack of school readiness among this population-based cohort.
Collapse
Affiliation(s)
- Deepak Louis
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sapna Oberoi
- Division of Pediatric Hematology/Oncology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - M. Florencia Ricci
- Neonatal Follow up Program, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christy Pylypjuk
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ruben Alvaro
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mary Seshia
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Cecilia de Cabo
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Diane Moddemann
- Neonatal Follow up Program, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lisa M. Lix
- Department of Community Health Sciences, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Allan Garland
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Medicine, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Chelsea A. Ruth
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
4
|
Bando N, Walton K, O'Connor DL, Janus M, Unger SL. Examination of school readiness and factors related to developmental vulnerability in children born very low birth weight. Child Care Health Dev 2022; 49:444-455. [PMID: 36070087 DOI: 10.1111/cch.13058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 08/02/2022] [Accepted: 09/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many children born very low birth weight (VLBW) experience school struggles with preparedness requiring adequate physical, social, behavioural, cognitive and communication skills. A global assessment of proficiency is necessary to identify those at risk in any such area and direct early intervention accordingly. Study objectives were to characterize developmental vulnerability and school readiness scores in these key domains in a sample of children born VLBW versus their provincial public school system peers and identify early-life infant and parent factors related to suboptimal school readiness. METHODS The Early Development Instrument teacher assessments of school readiness were collected for a Canadian VLBW sample (NCT02759809). Comparisons between children born VLBW and peers were made. Group differences between children born VLBW considered vulnerable (<10th percentile, not developmentally ready for learning) and not vulnerable were tested and linear regression explored associations between early-life factors and domain scores. RESULTS Of 77 available Early Development Instrument assessments, median (interquartile range) assessment age was 6.0 (5.7, 6.2) years, birth weight 950 (793, 1250) grammes and birth gestation 27.4 (25.6, 29.7) weeks. A higher proportion of children born VLBW versus peers exhibited vulnerability in Physical Health and Well-being (24.7% vs. 16.1%, p = 0.04), Communication Skills and General Knowledge (23.4% vs. 10.2%, p = 0.0001) and vulnerability in ≥2 domains (26.0% vs. 14.4%, p = 0.004). Children born VLBW classified as vulnerable versus not vulnerable had lower birth gestation and 5-min Apgar. Adjusted regression models found Apgar <7 associated with lower scores for Physical Health and Well-being (-0.86; 95%CI: -1.71, -0.00; p = 0.049), Social Competence (-1.77; 95%CI: -2.92, -0.62; p = 0.003), Emotional Maturity (-1.55; 95%CI: -2.43, -0.66; p = 0.0009) and Communication Skills and General Knowledge (-1.63; 95%CI: -3.19, -0.06; p = 0.04). CONCLUSIONS This VLBW sample exhibited poor school readiness in multiple domains. Identification of lower birth gestation and Apgar may assist targeted early interventions to mitigate vulnerability.
Collapse
Affiliation(s)
- Nicole Bando
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kathryn Walton
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Deborah L O'Connor
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Paediatrics, Sinai Health, Toronto, Ontario, Canada
| | - Magdalena Janus
- Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Sharon L Unger
- Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Paediatrics, Sinai Health, Toronto, Ontario, Canada.,Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Paediatrics, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
5
|
Perrin HT, Heller NA, Loe IM. School Readiness in Preschoolers With Symptoms of Attention-Deficit/Hyperactivity Disorder. Pediatrics 2019; 144:e20190038. [PMID: 31331986 PMCID: PMC6855898 DOI: 10.1542/peds.2019-0038] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To compare school readiness in preschoolers with and without attention-deficit/hyperactivity disorder (ADHD) symptoms using a comprehensive framework. We hypothesized that preschoolers with ADHD symptoms have higher odds of school readiness impairment. METHODS Children ages 4 to 5 years (n = 93) were divided into 2 groups on the basis of presence of ADHD symptoms (ADHD group, n = 45; comparison group, n = 48). School readiness was assessed through 10 component measures, including direct assessments and standardized questionnaires, regarding 5 school readiness domains: physical well-being and motor development, social and emotional development, approaches to learning, language, and cognition and general knowledge. Analysis of covariance compared group mean scores on component measures. Domain impairment was defined as score ≥1 SD from the test population mean in the unfavorable direction on ≥1 measure in the domain. School readiness impairment was defined as impairment in ≥2 of 5 domains. Logistic regression predicted impairment within domains and overall readiness. RESULTS The ADHD group demonstrated significantly worse mean scores on 8 of 10 component measures and greater odds of impairment in all domains except for cognition and general knowledge. Overall, 79% of the ADHD group and 13% of the comparison group had school readiness impairment (odds ratio 21, 95% confidence interval 5.67-77.77, P < .001). CONCLUSIONS Preschoolers with ADHD symptoms are likely to have impaired school readiness. We recommend early identification of school readiness impairment by using a comprehensive 5-domain framework in children with ADHD symptoms paired with targeted intervention to improve outcomes.
Collapse
Affiliation(s)
- Hannah T Perrin
- Department of Pediatrics, School of Medicine, Stanford University, Stanford, California
| | - Nicole A Heller
- Department of Pediatrics, School of Medicine, Stanford University, Stanford, California
| | - Irene M Loe
- Department of Pediatrics, School of Medicine, Stanford University, Stanford, California
| |
Collapse
|
6
|
Kooiker MJG, Swarte RMC, Smit LS, Reiss IKM. Perinatal risk factors for visuospatial attention and processing dysfunctions at 1 year of age in children born between 26 and 32 weeks. Early Hum Dev 2019; 130:71-79. [PMID: 30703620 DOI: 10.1016/j.earlhumdev.2019.01.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 12/03/2018] [Accepted: 01/19/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Children born preterm are at risk of visuospatial attention orienting and processing dysfunctions, which can be quantified early in life using visually-guided eye movement responses. AIMS To identify the prevalence and perinatal risk factors for visuospatial attention orienting and processing dysfunctions in children born preterm of 1 year of corrected age (CA). STUDY DESIGN 123 children born between 26 and 33 weeks of gestation underwent a nonverbal visuospatial test at 1y CA, using an eye tracking-based paradigm. For the detected high-salient (cartoon and contrast), intermediate-salient (form and motion) and low-salient (color) stimuli, we quantified the reaction time to fixation (RTF). RTFs were compared to normative references from an age-matched control group (N = 38). The prevalence of perinatal risk factors (gestational age and weight, indices of neurological damage, overal sickness, respiratory failure, and retinopathy) was compared between the groups with normal and delayed RTFs. RESULTS At 1y CA, the preterm group had 7-20% less detected stimuli than the control group, particularly for intermediate and low-salient stimuli. Compared to normative RTFs, modest delays were found for high-salient cartoon (in 19% of preterm children) and contrast (8%), intermediate-salient motion (23%) and form (21%), and low-salient color stimuli (8%). These children had a significantly higher prevalence of perinatal risk factors for respiratory failure and intraventricular hemorrhages. CONCLUSIONS Children born between 26 and 32 weeks have a modest risk (8-23%) of visuospatial attention and processing dysfunction. This warrants early monitoring and support of general visual development in preterm children at risk of respiratory distress and disrupted cerebral blood flow.
Collapse
Affiliation(s)
- M J G Kooiker
- Vestibular and Oculomotor Research Group, Department of Neuroscience, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - R M C Swarte
- Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, the Netherlands
| | - L S Smit
- Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, the Netherlands; Department of Neurology, Division of Pediatric Neurology, Erasmus MC - Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, the Netherlands
| | - I K M Reiss
- Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, the Netherlands
| |
Collapse
|
7
|
Fink G, Andrews KG, Brentani H, Grisi S, Scoleze Ferrer AP, Brentani A. Overall and Sex-Specific Associations Between Fetal Adversity and Child Development at Age 1 Year: Evidence From Brazil. Am J Epidemiol 2018; 187:2324-2331. [PMID: 29982368 PMCID: PMC6211242 DOI: 10.1093/aje/kwy141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 06/28/2018] [Indexed: 01/09/2023] Open
Abstract
A growing body of epigenetic research suggests that in-utero adaptations to environmental changes display important sex-specific variation. We tested this heterogeneous adaptation hypothesis using data from 900 children born at the University Hospital in São Paulo, Brazil, between October 2013 and April 2014. Crude and adjusting linear models were used to quantify the associations between prematurity, being small for gestational age, and children’s physical and mental development at 12 months of age. Prematurity was negatively associated with neuropsychological development in final models (z score difference, −0.42, 95% confidence intervals: −0.71, −0.14), but associations did not vary significantly by sex. For being small for gestational age, associations with height-for-age, weight-for-age, and neuropsychological development were also negative, but they were systematically larger for male than for female infants (P < 0.05 for all). These results suggest that male fetuses may be more vulnerable to intrauterine adversity than female fetuses. Further research will be needed to better understand the mechanisms underlying these sex-specific associations.
Collapse
Affiliation(s)
- Günther Fink
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kathryn G Andrews
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Helena Brentani
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Sandra Grisi
- Department of Pediatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ana Paula Scoleze Ferrer
- Child Institute—Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Alexandra Brentani
- Department of Pediatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
8
|
Peterson JW, Loeb S, Chamberlain LJ. The Intersection of Health and Education to Address School Readiness of All Children. Pediatrics 2018; 142:peds.2018-1126. [PMID: 30366953 DOI: 10.1542/peds.2018-1126] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/31/2018] [Indexed: 11/24/2022] Open
Abstract
Children who enter kindergarten healthy and ready to learn are more likely to succeed academically. Children at the highest risk for not being ready for school live in poverty and/or with chronic health conditions. High-quality early childhood education (ECE) programs can be used to help kids be ready for school; however, the United States lacks a comprehensive ECE system, with only half of 3- and 4-year-olds being enrolled in preschool, lagging behind 28 high-income countries. As addressing social determinants of health gains prominence in pediatric training and practice, there is increasing interest in addressing ECE disparities. Unfortunately, evidence is lacking for clinically based, early educational interventions. New interventions are being developed asynchronously in pediatrics and education, often without knowledge of the evidence base in the other's literature. In this State-of-the-Art Review, we synthesize the relevant work from the field of education (searchable through the Education Resources Information Center, also known as the "PubMed" of education), combining it with relevant literature in PubMed, to align the fields of pediatrics and education to promote this timely transdisciplinary work. First, we review the education literature to understand the current US achievement gap. Next, we provide an update on the impact of child health on school readiness and explore emerging solutions in education and pediatrics. Finally, we discuss next steps for future transdisciplinary work between the fields of education and pediatrics to improve the health and school readiness of young children.
Collapse
Affiliation(s)
| | - Susanna Loeb
- Center for Education Policy Analysis, Graduate School of Education, Stanford University, Palo Alto, California
| | | |
Collapse
|
9
|
Voller SMB. 50 Years Ago in The Journal of Pediatrics: Neurologic Status of Survivors of Neonatal Respiratory Distress Syndrome. J Pediatr 2018; 200:239. [PMID: 30144921 DOI: 10.1016/j.jpeds.2018.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Stephannie M B Voller
- Division of Pediatric Neonatology Ann and Robert H. Lurie Children's Hospital of Chicago Chicago, Illinois
| |
Collapse
|
10
|
Fink E, Browne WV, Hughes C, Gibson J. Using a “child's-eye view” of social success to understand the importance of school readiness at the transition to formal schooling. SOCIAL DEVELOPMENT 2018. [DOI: 10.1111/sode.12323] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
11
|
Respiratory distress syndrome in preterm infants and risk of epilepsy in a Danish cohort. Eur J Epidemiol 2017; 33:313-321. [DOI: 10.1007/s10654-017-0308-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 08/31/2017] [Indexed: 10/18/2022]
|
12
|
Shah PE, Kaciroti N, Richards B, Lumeng JC. Gestational Age and Kindergarten School Readiness in a National Sample of Preterm Infants. J Pediatr 2016; 178:61-67. [PMID: 27470694 PMCID: PMC5085846 DOI: 10.1016/j.jpeds.2016.06.062] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 04/21/2016] [Accepted: 06/06/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the association of gestational age with school readiness in kindergarten reading and math skills. We hypothesized that compared with infants born at 39-41 weeks, infants born at lower gestational ages would have poorer school readiness. STUDY DESIGN The study sample comprised 5250 children from the Early Childhood Longitudinal Study, Birth Cohort, assessed with specialized reading and math assessments at kindergarten. Poor school readiness was characterized by reading and math theta scores ≥1.5 SD below the sample mean. The aOR and 95% CI of poor school readiness were estimated using multivariate logistic regression, examining gestational age continuously and categorically (very preterm [VPT], moderate/late preterm [M/LPT], early term [ET], and term). Pairwise comparisons were performed to test for differences by gestational age category. RESULTS There was an association between gestational age and poor school readiness for reading and math, with the suggestion of a threshold effect in children born at ≥32 weeks gestation. In adjusted models, in VPT infants, the aORs of poor school readiness in reading and math were 2.58 (95% CI, 1.29-5.15) and 3.38 (95% CI, 1.66-6.91), respectively. For infants born M/LPT and ET, the odds of poor school readiness in reading did not differ from those of children born full-term, however. CONCLUSIONS Compared with term infants, the highest odds of poor school readiness in reading and math were seen in VPT infants, with lower odds of poor school readiness in children born at ≥32 weeks gestation. Ongoing developmental surveillance before kindergarten is indicated for VPT infants.
Collapse
Affiliation(s)
- Prachi E Shah
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, Medical School, University of Michigan, Ann Arbor, MI; Center for Human Growth and Development, University of Michigan, Ann Arbor, MI.
| | - Niko Kaciroti
- Department of Biostatistics, School of Public of Health, University of Michigan, Ann Arbor, MI; Department of Nutritional Sciences, School of Public of Health, University of Michigan, Ann Arbor, MI
| | - Blair Richards
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
| | - Julie C Lumeng
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, Medical School, University of Michigan, Ann Arbor, MI; Center for Human Growth and Development, University of Michigan, Ann Arbor, MI; Department of Nutritional Sciences, School of Public of Health, University of Michigan, Ann Arbor, MI
| |
Collapse
|
13
|
Thygesen SK, Olsen M, Østergaard JR, Sørensen HT. Respiratory distress syndrome in moderately late and late preterm infants and risk of cerebral palsy: a population-based cohort study. BMJ Open 2016; 6:e011643. [PMID: 27729347 PMCID: PMC5073618 DOI: 10.1136/bmjopen-2016-011643] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES Infant respiratory distress syndrome (IRDS) is a known risk factor for intracerebral haemorrhage/intraventricular haemorrhage (ICH/IVH) and periventricular leucomalacia. These lesions are known to increase the risk of cerebral palsy (CP). Thus, we wanted to examine the long-term risk of CP following IRDS in moderately late and late preterm infants. DESIGN Population-based cohort study. SETTING All hospitals in Denmark. PARTICIPANTS We used nationwide medical registries to identify a cohort of all moderately and late preterm infants (defined as birth during 32-36 full gestational weeks) born in Denmark in 1997-2007 with and without hospital diagnosed IRDS. MAIN OUTCOMES MEASURES We followed study participants from birth until first diagnosis of CP, emigration, death or end of follow-up in 2014. We computed the cumulative incidence of CP before age 8 years and used Cox's regression analysis to compute HRs of IRDS, comparing children with IRDS to those without IRDS. HRs were adjusted for multiple covariates. RESULTS We identified 39 420 moderately late and late preterm infants, of whom 2255 (5.7%) had IRDS. The cumulative incidence of CP was 1.9% in infants with IRDS and 0.5% in the comparison cohort. The adjusted HR of CP was 2.0 (95% CI 1.4 to 2.9). The adjusted HR of CP was 12 (95% CI 4.5 to 34) in children with IRDS accompanied by a diagnosis of ICH/IVH. After restriction to children without diagnoses of perinatal breathing disorders other than IRDS, congenital heart disease and viral or bacterial infections occurring within 4 days of birth, the overall adjusted HR was 2.1 (95% CI 1.4 to 3.1). CONCLUSIONS The risk of CP was increased in moderately late and late preterm infants with IRDS compared with infants without IRDS born during the same gestational weeks.
Collapse
Affiliation(s)
| | - Morten Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
| | - John R Østergaard
- Department of Paediatrics, Aarhus University Hospital, Aarhus N, Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
- Departments of Health Research and Policy (Epidemiology), Stanford University, Stanford, California, USA
| |
Collapse
|
14
|
Woolfenden S, Eapen V, Jalaludin B, Hayen A, Kemp L, Dissanyake C, Hendry A, Axelsson E, Overs B, Eastwood J, Črnčec R, McKenzie A, Beasley D, Murphy E, Williams K. Prevalence and factors associated with parental concerns about development detected by the Parents' Evaluation of Developmental Status (PEDS) at 6-month, 12-month and 18-month well-child checks in a birth cohort. BMJ Open 2016; 6:e012144. [PMID: 27609853 PMCID: PMC5020845 DOI: 10.1136/bmjopen-2016-012144] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Early identification of developmental vulnerability is vital. This study aimed to estimate the prevalence of moderate or high developmental risk on the Parents' Evaluation of Developmental Status (PEDS) at 6-month, 12-month and 18-month well-child checks; identify associated risk factors; and examine documentation of the PEDS at well-child checks. DESIGN, PARTICIPANTS A prospective birth cohort of 2025 children with 50% of those approached agreeing to participate. Demographic data were obtained via questionnaires and linked electronic medical records. Telephone interviews were conducted with parents to collect PEDS data. PRIMARY AND SECONDARY OUTCOMES Multiple logistic regression analyses identified risk factors for moderate or high developmental risk on the PEDS. A Cumulative Risk Index examined the impact of multiple risk factors on developmental risk and documentation of the PEDS at the well-child checks. RESULTS Of the original cohort, 792 (39%) had 6-month, 649 (32%) had 12-month and 565 (28%) had 18-month PEDS data. Parental concerns indicating moderate or high developmental risk on the PEDS were 27% (95% CI 24 to 30) at 6 months, 27% (95% CI 24 to 30) at 12 months and 33% (95% CI 29 to 37) at 18 months. Factors associated with moderate or high developmental risk were perinatal risk (OR 12 months: 1.7 (95% CI 1.1 to 2.7)); maternal Middle Eastern or Asian nationality (OR 6 months: 1.6 (95% CI 1.1 to 2.4)), (OR 12 months: 1.7 (95% CI 1.1 to 2.7)); and household disadvantage (OR 6 months: 1.5 (95% CI 1.0 to 2.2). As the number of risk factors increased the odds increased for high or moderate developmental risk and no documentation of the PEDS at well-child checks. CONCLUSIONS Children with multiple risk factors are more likely to have parental concerns indicating developmental vulnerability using the PEDS and for these concerns to not be documented.
Collapse
Affiliation(s)
- Susan Woolfenden
- Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Valsamma Eapen
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, New South Wales, Australia
- School of Psychiatry & Ingham Institute, University of New South Wales, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- Epidemiology Group, Healthy People and Places Unit, South Western Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Andrew Hayen
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Lynn Kemp
- School of Nursing and Midwifery, University of Western Sydney, Penrith South DC, New South Wales, Australia
| | - Cheryl Dissanyake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, South Australia, Australia
| | - Alexandra Hendry
- Early Years Research Group, Ingham Institute, Sydney South West Local Health District, Sydney, New South Wales, Australia
| | - Emma Axelsson
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- Research School of Psychology, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Bronwyn Overs
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, New South Wales, Australia
| | - John Eastwood
- Community Paediatrics, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Rudi Črnčec
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, New South Wales, Australia
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Anne McKenzie
- Sydney South West Local Health District, Australia,Sydney, New South Wales, Australia
| | - Deborah Beasley
- Office of Kids and Families (NSW Health), North Sydney, New South Wales, Australia
| | - Elisabeth Murphy
- Office of Kids and Families (NSW Health), North Sydney, New South Wales, Australia
| | - Katrina Williams
- Department of Paediatrics, University of Melbourne, Melbourne, South Australia, Australia
- Developmental Medicine, Royal Children's Hospital, Melbourne, South Australia, Australia
- Murdoch Children's Research Institute, Melbourne, South Australia, Australia
| |
Collapse
|
15
|
Brumberg HL, Shah SI. Born early and born poor: An eco-bio-developmental model for poverty and preterm birth. J Neonatal Perinatal Med 2016; 8:179-87. [PMID: 26485551 DOI: 10.3233/npm-15814098] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Poverty is associated with adverse long-term cognitive outcomes in children. Poverty is also linked with preterm delivery which, in turn, is associated with adverse cognitive outcomes. However, the extent of the effect of poverty on preterm delivery, as well as proposed mechanisms by which they occur, have not been well described. Further, the impact of poverty on preterm school readiness has not been reviewed. As the childhood poverty level continues to increase in the U.S., we examine the evidence around physiological, neurological, cognitive and learning outcomes associated with prematurity in the context of poverty. We use the evidence gathered to suggest an Eco-Bio-Developmental model, emphasizing poverty as a toxic stress which predisposes preterm birth and which, via epigenetic forces, can continue into the next generation. Continued postnatal social disadvantage for these developmentally high-risk preterm infants is strongly linked with poor neurodevelopmental outcomes, decreased school readiness, and decreased educational attainment which can perpetuate the poverty cycle. We suggest social remedies aimed at decreasing the impact of poverty on mothers, fathers, and children which may be effective in reducing the burden of preterm birth.
Collapse
Affiliation(s)
- H L Brumberg
- Division of Neonatology, The Regional Perinatal Center, Maria Fareri Children's Hospital at Westchester Medical Center, NY, USA
| | - S I Shah
- New York Medical College, Division of Neonatology, Maria Fareri Children's Hospital, NY, USA
| |
Collapse
|
16
|
Ford RM, Griffiths S, Neulinger K, Andrews G, Shum DHK, Gray PH. Impaired prospective memory but intact episodic memory in intellectually average 7- to 9-year-olds born very preterm and/or very low birth weight. Child Neuropsychol 2016; 23:954-979. [PMID: 27539515 DOI: 10.1080/09297049.2016.1216091] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Relatively little is known about episodic memory (EM: memory for personally-experienced events) and prospective memory (PM: memory for intended actions) in children born very preterm (VP) or with very low birth weight (VLBW). This study evaluates EM and PM in mainstream-schooled 7- to 9-year-olds born VP (≤ 32 weeks) and/or VLBW (< 1500 g) and matches full-term children for comparison (n = 35 and n = 37, respectively). Additionally, participants were assessed for verbal and non-verbal ability, executive function (EF), and theory of mind (ToM). The results show that the VP/VLBW children were outperformed by the full-term children on the memory tests overall, with a significant univariate group difference in PM. Moreover, within the VP/VLBW group, the measures of PM, verbal ability and working memory all displayed reliable negative correlations with severity of neonatal illness. PM was found to be independent of EM and cognitive functioning, suggesting that this form of memory might constitute a domain of specific vulnerability for VP/VLBW children.
Collapse
Affiliation(s)
- Ruth M Ford
- a Department of Psychology , Anglia Ruskin University , Cambridge , UK
| | - Sarah Griffiths
- b Menzies Health Institute Queensland and School of Applied Psychology , Griffith University , Queensland , Australia
| | - Kerryn Neulinger
- b Menzies Health Institute Queensland and School of Applied Psychology , Griffith University , Queensland , Australia
| | - Glenda Andrews
- b Menzies Health Institute Queensland and School of Applied Psychology , Griffith University , Queensland , Australia
| | - David H K Shum
- b Menzies Health Institute Queensland and School of Applied Psychology , Griffith University , Queensland , Australia
| | - Peter H Gray
- c Mater Research Institute , University of Queensland and Mater Mothers' Hospital , Queensland , Australia
| |
Collapse
|
17
|
de Laat SAA, Essink-Bot ML, van Wassenaer-Leemhuis AG, Vrijkotte TG. Effect of socioeconomic status on psychosocial problems in 5- to 6-year-old preterm- and term-born children: the ABCD study. Eur Child Adolesc Psychiatry 2016; 25:757-67. [PMID: 26564020 PMCID: PMC4932131 DOI: 10.1007/s00787-015-0791-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 10/27/2015] [Indexed: 01/18/2023]
Abstract
This study aimed at analysing the association between socioeconomic status (SES) and psychosocial problems in preterm- and term-born children. Scores of mothers and teachers on the Strengths and Difficulties Questionnaire (SDQ) regarding 217 preterm-born children (<37 weeks' gestation, mean 34 weeks) were compared with 4336 term-born children in the Amsterdam Born Children and their Development (ABCD) cohort at age 5-6 years. Associations between SDQ scores and SES (maternal education and perceived income adequacy) were examined with multivariate linear regression analysis. The mean mother-reported total difficulties score was significantly higher for preterm children (6.1 ± 4.7) than for term children (5.2 ± 4.1). After covariate adjustment, this difference was 0.5 (95 % CI 0.0-1.0). For preterm children 16.1 % of the mothers reported psychosocial problems compared with 10.1 % for term children. Lower maternal education and lower income adequacy were significantly related to higher SDQ scores of mothers and teachers. Differences in mothers' SDQ score between preterm and term children were larger in the high-education (Δ0.9, 95 % CI 0.2-1.5) and high-income group (Δ0.9, 95 % CI 0.3-1.6). No significant differences were found between preterm and term children in the SDQ scores reported by teachers. Low level of maternal education and inadequate income showed a much stronger association with psychosocial problems than preterm birth. No combined effect of low SES and preterm birth was found. This study corroborates the evidence for the strength of the disadvantageous effects of low SES on early psychosocial development.
Collapse
Affiliation(s)
- Sanne A. A. de Laat
- Department of Public Health, Academic Medical Center (AMC), Amsterdam, The Netherlands ,Youth Health Care, GGD Hart voor Brabant, ‘s-Hertogenbosch, The Netherlands
| | | | | | - Tanja G. Vrijkotte
- Department of Public Health, Academic Medical Center (AMC), Amsterdam, The Netherlands
| |
Collapse
|
18
|
Early physical health conditions and school readiness skills in a prospective birth cohort of U.S. children. Soc Sci Med 2015; 142:145-53. [PMID: 26310590 DOI: 10.1016/j.socscimed.2015.08.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 08/12/2015] [Accepted: 08/14/2015] [Indexed: 02/02/2023]
Abstract
RATIONALE Extant research identifies associations between early physical health disparities and impaired functioning in adulthood, but limited research examines the emergence of these associations in the early years of children's lives. OBJECTIVE This study draws on data from the Early Childhood Longitudinal Study Birth Cohort (ECLS-B; N = 5900) to assess whether a host of early health indicators measured from birth to age five are associated with children's cognitive and behavioral skills at age five. RESULTS After adjusting for child and family characteristics, results revealed that children's neonatal risks (prematurity or low birth weight) and reports of poor health and hospitalizations were associated with lower cognitive skills, and neonatal risks and poor health predicted lower behavioral functioning at age five. Some of the association between neonatal risks and school readiness skills were indirect, functioning through children's poor health and hospitalization. Analyses further found that associations between early physical health and children's school readiness skills were consistent across subgroups defined by family income and child race/ethnicity, suggesting generalizability of results. CONCLUSIONS Findings emphasize the need for more interdisciplinary research, practice, and policy related to optimizing child well-being across domains of physical health and development in the early years of life.
Collapse
|
19
|
Woolfenden S, Williams K, Eapen V, Mensah F, Hayen A, Siddiqi A, Kemp L. Developmental vulnerability--don't investigate without a model in mind. Child Care Health Dev 2015; 41:337-45. [PMID: 25088700 DOI: 10.1111/cch.12181] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2014] [Indexed: 11/30/2022]
Abstract
Children who are developmentally vulnerable are at risk of a difficult start to school, and ongoing educational challenges which may adversely impact on long term health outcomes. Clinicians, researchers and service providers need a thorough understanding of both risk and protective factors and their complex interplay to understand their impact on early childhood development, in order to plan effective and comprehensive prevention and interventions strategies. In this opinion piece we recommend that investigation of developmental vulnerability should only proceed if underpinned by both a theoretical model through which the interaction between risk and protective factors may be investigated, and analytical models that are appropriate to assess these impacts.
Collapse
Affiliation(s)
- S Woolfenden
- Sydney Children's Hospital Network, Sydney, NSW, Australia
| | | | | | | | | | | | | |
Collapse
|
20
|
Brown L, Burns YR, Watter P, Gibbons KS, Gray PH. Motor performance, postural stability and behaviour of non-disabled extremely preterm or extremely low birth weight children at four to five years of age. Early Hum Dev 2015; 91:309-15. [PMID: 25841102 DOI: 10.1016/j.earlhumdev.2015.03.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 01/13/2015] [Accepted: 03/12/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Extremely preterm or extremely low birth weight (ELBW) children who are non-disabled and otherwise healthy are at risk of neurodevelopmental impairments. Further understanding of these impairments is needed before commencement of formal education to optimise participation levels at a critical time point for these children. AIMS To explore motor co-ordination, postural stability, limb strength and behaviour of non-disabled four to five year old children with a history of extreme prematurity or ELBW. STUDY DESIGN Prospective-descriptive-cohort-study. SUBJECTS 50 children born at less than 28 weeks gestation or who had a birth weight less than 1000g with minimal/mild motor impairments and no significant neurological/cognitive impairments. OUTCOME MEASURES Movement Assessment Battery for Children second-edition (MABC-2), single leg stance test (SLS), lateral reach test, standing long jump test and Child Behaviour Checklist for preschool children (CBCL). RESULTS The mean percentile rank of the extremely preterm or ELBW sample on MABC-2 was 31% (SD 23%). SLS right (mean ± SD; 4.6 ± 2.5s) and lateral reach to the right (10.0 ± 3.9 cm) were slightly stronger than SLS left (4.4 ± 3.3s) and lateral reach left (9.9 ± 3.5 cm). The average for standing long jump was 71.6 cm (SD 21.0 cm). All participants were classified as 'normal' on CBCL syndrome scale scores, internalizing and externalizing syndrome T scores and total problem T score. CONCLUSIONS This sample of non-disabled extremely preterm or ELBW children performed in the lower range of normal. These children continue to be at risk of impairments, therefore, ongoing monitoring and tailored intervention may optimise development.
Collapse
Affiliation(s)
- Laura Brown
- Growth and Development Unit, Mater Mothers' Hospital, Raymond Terrace, South Brisbane, Queensland 4101, Australia; The University of Queensland, St Lucia, Queensland 4072, Australia.
| | - Yvonne R Burns
- Growth and Development Unit, Mater Mothers' Hospital, Raymond Terrace, South Brisbane, Queensland 4101, Australia; The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Pauline Watter
- The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Kristen S Gibbons
- Mater Research Institute, University of Queensland, Raymond Terrace, South Brisbane, Queensland 4101, Australia
| | - Peter H Gray
- Growth and Development Unit, Mater Mothers' Hospital, Raymond Terrace, South Brisbane, Queensland 4101, Australia; Mater Research Institute, University of Queensland, Raymond Terrace, South Brisbane, Queensland 4101, Australia
| |
Collapse
|
21
|
Hodel AS, Brumbaugh JE, Morris AR, Thomas KM. Hot executive function following moderate-to-late preterm birth: altered delay discounting at 4 years of age. Dev Sci 2015; 19:221-34. [PMID: 25873181 DOI: 10.1111/desc.12307] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 02/18/2015] [Indexed: 01/08/2023]
Abstract
Interest in monitoring long-term neurodevelopmental outcomes of children born moderate-to-late preterm (32-36 weeks gestation) is increasing. Moderate-to-late preterm birth has a negative impact on academic achievement, which may relate to differential development of executive function (EF). Prior studies reporting deficits in EF in preterm children have almost exclusively assessed EF in affectively neutral contexts in high-risk preterm children (< 32 weeks gestation). Disrupted function in motivational or emotionally charged contexts (hot EF) following preterm birth remains uninvestigated, despite evidence that preterm children show differential development of neural circuitry subserving hot EF, including reduced orbitofrontal cortex volume. The present study is the first to examine whether low-risk, healthy children born moderate-to-late preterm exhibit impairments in the development of hot EF. Preterm children at age 4.5 years were less likely to choose larger, delayed rewards across all levels of reward magnitude on a delay discounting task using tangible rewards, but performed more similarly to their full-term peers on a delay aversion task involving abstract rewards and on measures of cool EF. The relationship between gestational age at birth and selection of delayed rewards extended across the entire gestational age range of the sample (32-42 weeks), and remained significant after controlling for intelligence and processing speed. Results imply that there is not a finite cut-off point at which children are spared from potential long-term neurodevelopmental effects of PT birth. Further investigation of reward processing and hot EF in individuals with a history of PT birth is warranted given the susceptibility of prefrontal cortex development to early environmental variations.
Collapse
Affiliation(s)
- Amanda S Hodel
- Institute of Child Development, University of Minnesota, USA
| | - Jane E Brumbaugh
- Stead Family Department of Pediatrics, University of Iowa Hospitals and Clinics, USA
| | - Alyssa R Morris
- Institute of Child Development, University of Minnesota, USA
| | | |
Collapse
|
22
|
Woolfenden S, Eapen V, Williams K, Hayen A, Spencer N, Kemp L. A systematic review of the prevalence of parental concerns measured by the Parents' Evaluation of Developmental Status (PEDS) indicating developmental risk. BMC Pediatr 2014; 14:231. [PMID: 25218133 PMCID: PMC4175611 DOI: 10.1186/1471-2431-14-231] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 09/02/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parental concerns about their children's development can be used as an indicator of developmental risk. We undertook a systematic review of the prevalence of parents' concerns as an indicator of developmental risk, measured by the Parents' Evaluation of Developmental Status (PEDS) and associated risk factors. METHODS Electronic databases, bibliographies and websites were searched and experts contacted. Studies were screened for eligibility and study characteristics were extracted independently by two authors. A summary estimate for prevalence was derived. Meta-regression examined the impact of study characteristics and quality. Meta-analysis was used to derive pooled estimates of the impact of biological and psychosocial risk factors on the odds of parental concerns indicating high developmental risk. RESULTS Thirty seven studies were identified with a total of 210,242 subjects. Overall 13.8% (95% CI 10.9 -16.8%) of parents had concerns indicating their child was at high developmental risk and 19.8% (95% CI 16.7-22.9%) had concerns indicating their child was at moderate developmental risk. Male gender, low birth weight, poor/fair child health rating, poor maternal mental health, lower socioeconomic status (SES), minority ethnicity, not being read to, a lack of access to health care and not having health insurance were significantly associated with parental concerns indicating a high developmental risk. CONCLUSIONS The prevalence of parental concerns measured with the PEDS indicating developmental risk is substantial. There is increased prevalence associated with biological and psychosocial adversity. TRIAL REGISTRATION PROSPERO Registration: CRD42012003215.
Collapse
Affiliation(s)
- Susan Woolfenden
- />Department of Community Child Health, Sydney Children’s Hospital Network, High St Randwick NSW 2031, Sydney, Australia
- />School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Valsamma Eapen
- />School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Katrina Williams
- />Royal Children’s Hospital and Murdoch Children’s Research Institute, University of Melbourne, Melbourne, Australia
| | - Andrew Hayen
- />School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | | | - Lynn Kemp
- />School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| |
Collapse
|
23
|
Pritchard VE, Bora S, Austin NC, Levin KJ, Woodward LJ. Identifying very preterm children at educational risk using a school readiness framework. Pediatrics 2014; 134:e825-32. [PMID: 25113296 DOI: 10.1542/peds.2013-3865] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Children born very preterm (VPT) are at high risk of educational delay, yet few guidelines exist for the early identification of those at greatest risk. Using a school readiness framework, this study examined relations between preschool neurodevelopmental functioning and educational outcomes to age 9 years. METHODS The sample consisted of a regional cohort of 110 VPT (≤ 32 weeks' gestation) and 113 full-term children born during 1998-2000. At corrected age 4 years, children completed a multidisciplinary assessment of their health/motor development, socioemotional adjustment, core learning skills, language, and general cognition. At ages 6 and 9, children's literacy and numeracy skills were assessed using the Woodcock-Johnson III Tests of Achievement. RESULTS Across all readiness domains, VPT children were at high risk of delay/impairment (odds ratios 2.5-3.5). Multiple problems were also more common (47% vs 16%). At follow-up, almost two-thirds of VPT children were subject to significant educational delay in either literacy, numeracy or both compared with 29% to 31% of full-term children (odds ratios 3.4-4.4). The number of readiness domains affected at age 4 strongly predicted later educational risk, especially when multiple problems were present. Receiver operating characteristic analysis confirmed ≥ 2 readiness problems as the optimal threshold for identifying VPT children at educational risk. CONCLUSIONS School readiness offers a promising framework for the early identification of VPT children at high educational risk. Findings support the utility of ≥ 2 affected readiness domains as an effective criterion for referral for educational surveillance and/or additional support during the transition to school.
Collapse
Affiliation(s)
| | - Samudragupta Bora
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nicola C Austin
- Neonatal Service, Christchurch Women's Hospital, Christchurch, New Zealand; Department of Pediatrics, University of Otago, Christchurch, New Zealand; and
| | - Karelia J Levin
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Lianne J Woodward
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Psychology, University of Canterbury, Christchurch, New Zealand
| |
Collapse
|
24
|
Gehrmann FE, Coleman A, Weir KA, Ware RS, Boyd RN. School readiness of children with cerebral palsy. Dev Med Child Neurol 2014; 56:786-93. [PMID: 24433312 DOI: 10.1111/dmcn.12377] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2013] [Indexed: 11/29/2022]
Abstract
AIM To examine school readiness in preschool-age children with cerebral palsy (CP) on three of five domains compared with reported norms of children with typical development (CTD). METHOD A representative population of 151 preschool-age children with CP (87 males, 64 females; 131 [87%] with spasticity, 17 [11%] dyskinesia, 3 [4%] hypotonia) were assessed at 48 or 60 months corrected age. Children were functioning in the following Gross Motor Function Classification System (GMFCS) levels: I, 74 (49%); II, 17 (11%); III, 14 (9%); IV, 26 (17%); V, 20 (13%). Children's motor performance, self-care, and social function were assessed using the Pediatric Evaluation of Disability Inventory (PEDI) and communication using the Communication and Symbolic Behaviour Scales Developmental Profile (CSBS-DP). Results were compared with a reference sample of CTD (PEDI CTD n=412; CSBS-DP CTD n=790). Linear regression was used to compare these data by functional severity. RESULTS Children with CP had significantly lower PEDI scores in all domains than CTD. Self-care scores ranged from 0.5 to more than 4SD below CTD, motor performance was 2 to >4SD below CTD, and social function between 0.5 and >4SD below CTD. Fifty-five per cent of children demonstrated significantly delayed communication skills. Non-ambulant children displayed significantly lower scores than ambulant children. INTERPRETATION Preschool-age children with CP perform significantly below their peers in three of five key readiness-to-learn skill areas including mobility, self-care, social function, and communication abilities. Broader emphasis needs to be placed on multimodal screening and intervention to prepare children with CP for school entry.
Collapse
Affiliation(s)
- Frances E Gehrmann
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Qld, Australia; School of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | | | | | | | | |
Collapse
|
25
|
Developmental and mental health disorders: two sides of the same coin. Asian J Psychiatr 2014; 8:7-11. [PMID: 24655619 DOI: 10.1016/j.ajp.2013.10.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 10/05/2013] [Accepted: 10/09/2013] [Indexed: 02/07/2023]
Abstract
Children with developmental disorders (DD) are at substantially greater risk of developing mental health problems compared to typically developing children. However, the mental health co-morbidity is often missed or hidden in the context of DD leading to reduced quality of life and increased burden of care. Mental health problems in the context of DD also result in less optimal school and post-school outcomes with reduced opportunities for employment and community participation. There is also considerable overlap in the risk factors for both conditions, and these follow a cumulative risk model. Although awareness among clinicians and the public is improving, there is paucity of theoretical models, early identification frameworks as well as care pathways for interventions. This paper presents a framework for evaluating developmental vulnerability that highlights common risk factors for developmental and mental health disorders.
Collapse
|
26
|
Ho DST, Leung C, Lo SK. Validation of the Gumpel Readiness Inventory for preschool children in Hong Kong. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3066-3076. [PMID: 23886752 DOI: 10.1016/j.ridd.2013.05.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 05/18/2013] [Accepted: 05/22/2013] [Indexed: 06/02/2023]
Abstract
The aim of this study was to validate the Chinese version of the Gumpel Readiness Inventory (RI). Participants included 653 preschool children aged three to five years old, their teachers and parents, and 49 children with developmental disabilities. Teachers and parents completed the RI and parents completed the Strength and Difficulty Questionnaire (SDQ) as well. Each child was individually assessed on the cognitive domain of Preschool Developmental Assessment Scale (PDAS). The results showed that the parent's and teacher's versions of RI correlated with SDQ and PDAS. The RI scores of the children with developmental disabilities were significantly lower than that of the children with typical development. Older children attained higher RI scores than younger children. The internal consistency and the test-retest reliability (both parent's and teacher's versions) were above .70. To conclude, the Chinese version of the RI is a reliable, valid and quick instrument for measuring the school readiness of Hong Kong preschool children.
Collapse
Affiliation(s)
- Dorothy Shu Ting Ho
- The Hong Kong Polytechnic University, The Hong Kong Institute of Education, Hong Kong
| | | | | |
Collapse
|
27
|
Woolfenden S, Goldfeld S, Raman S, Eapen V, Kemp L, Williams K. Inequity in child health: the importance of early childhood development. J Paediatr Child Health 2013; 49:E365-9. [PMID: 23551940 DOI: 10.1111/jpc.12171] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Susan Woolfenden
- Community Child Health, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | | | | | | | | | | |
Collapse
|
28
|
Janvier A, Lorenz JM, Lantos JD. Antenatal counselling for parents facing an extremely preterm birth: limitations of the medical evidence. Acta Paediatr 2012; 101:800-4. [PMID: 22497312 DOI: 10.1111/j.1651-2227.2012.02695.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED When physicians are asked for a consult for women in premature labour, they face a complex set of challenges. Policy statements recommend that women be given detailed information about the risks of various outcomes, including death, long-term disability and various specific neonatal problems. Both personal narratives and studies suggest that parents also base their decisions on factors other than the probabilistic facts about expected outcomes. Statistics are difficult to understand at any time. Rational decision-making may be difficult when taking life-and-death decisions. Furthermore, the role of emotions is not discussed in peri-viability guidelines. CONCLUSION We argue against trying to tell parents every fact that we think might be relevant to their decision. This may be overwhelming for many parents. Instead, doctors should try to discern, on a case-by-case basis, what particular parents want and need. Information and delivery of information should be personalized. Unfortunately, evidence in this area is limited.
Collapse
Affiliation(s)
- Annie Janvier
- Division of Neonatology and Clinical Ethics, Department of Pediatrics, University of Montreal, Sainte-Justine Hospital, Montreal, QC, Canada.
| | | | | |
Collapse
|
29
|
Andrews B, Lagatta J, Chu A, Plesha-Troyke S, Schreiber M, Lantos J, Meadow W. The nonimpact of gestational age on neurodevelopmental outcome for ventilated survivors born at 23-28 weeks of gestation. Acta Paediatr 2012; 101:574-8. [PMID: 22277021 DOI: 10.1111/j.1651-2227.2012.02609.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM It has long been known that survival of preterm infants strongly depends upon birth weight and gestational age. This study addresses a different question - whether the gestational maturity improves neurodevelopmental outcomes for ventilated infants born at 23-28 weeks who survive to neonatal intensive care unit (NICU) discharge. METHODS We performed a prospective cohort study of 199 ventilated infants born between 23 and 28 weeks of gestation. Neurodevelopmental impairment was determined using the Bayley Scales of Infant Development-II at 24 months. RESULTS As expected, when considered as a ratio of all births, both survival and survival without neurodevelopmental impairment were strongly dependent on gestational age. However, the percentage of surviving infants who displayed neurodevelopmental impairment did not vary with gestational age for any level of neurodevelopmental impairment (MDI or PDI <50, <60, <70). Moreover, as a higher percentage of ventilated infants survived to NICU discharge at higher gestational ages, but the percentage of neurodevelopmental impairment in NICU survivors was unaffected by gestational age, the percentage of all ventilated births who survived with neurodevelopmental impairment rose - not fell - with increasing gestation age. CONCLUSION For physicians, parents and policy-makers whose primary concern is the presence of neurodevelopmental impairment in infants who survive the NICU, reliance on gestational age appears to be misplaced.
Collapse
Affiliation(s)
- Bree Andrews
- Department of Pediatrics, The University of Chicago, IL 60637, USA
| | | | | | | | | | | | | |
Collapse
|
30
|
Effectiveness of a combined home visiting and group intervention for low income African American mothers: the pride in parenting program. Matern Child Health J 2012; 15 Suppl 1:S75-84. [PMID: 21792546 DOI: 10.1007/s10995-011-0858-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Intervention strategies are needed to improve maternal and infant outcomes in minority populations living in poverty. Home visiting by nurses has improved outcomes for mothers and young children, but use of professional staff makes these programs expensive. Pride in Parenting was a randomized controlled trial of paraprofessional home visitation to provide health and developmental intervention for high-risk African American mothers in Washington, DC. This study proposed to test whether paraprofessional visitors drawn from the community could effectively influence health and mothers' parenting behaviors and attitudes. African American mothers with inadequate prenatal care were recruited at delivery and randomized to intervention or usual care groups. The intervention curriculum was delivered through both home visitation and parent-infant groups for 1 year. The intervention curriculum was designed to improve knowledge, influence attitudes, and promote life skills that would assist low-income mothers in offering better health oversight and development for their infants. Both intervention and usual care groups received monthly social work contact over the one-year study period to provide referrals for identified needs. The intervention participants improved their home environments, a characteristic important for promoting good child development. Mothers' perceptions of available social support improved and child-rearing attitudes associated with child maltreatment were reduced. Paraprofessional home visitors can be successful in improving the child-rearing environments and parenting attitudes for infants at risk, perhaps offering a less costly option to professional home visitors.
Collapse
|
31
|
Abstract
Our objectives were to examine cognitive outcomes for extremely preterm/extremely low birth weight (EPT/ELBW, gestational age <28 weeks and/or birth weight <1000 g) children in kindergarten and the associations of these outcomes with neonatal factors, early childhood neurodevelopmental impairment, and socioeconomic status (SES). The sample comprised a hospital-based 2001-2003 birth cohort of 148 EPT/ELBW children (mean birth weight 818 g; mean gestational age 26 weeks) and a comparison group of 111 term-born normal birth weight (NBW) classmate controls. Controlling for background factors, the EPT/ELBW group had pervasive deficits relative to the NBW group on a comprehensive test battery, with rates of cognitive deficits that were 3 to 6 times higher in the EPT/ELBW group. Deficits on a measure of response inhibition were found in 48% versus 10%, odds ratio (95% confidence interval) = 7.32 (3.32, 16.16), p < .001. Deficits on measures of executive function and motor and perceptual-motor abilities were found even when controlling for acquired verbal knowledge. Neonatal risk factors, early neurodevelopmental impairment, and lower SES were associated with higher rates of deficits within the EPT/ELBW group. The findings document both global and selective cognitive deficits in EPT/ELBW children at school entry and justify efforts at early identification and intervention.
Collapse
|
32
|
Taylor HG, Klein N, Anselmo MG, Minich N, Espy KA, Hack M. Learning problems in kindergarten students with extremely preterm birth. ACTA ACUST UNITED AC 2011; 165:819-25. [PMID: 21893648 DOI: 10.1001/archpediatrics.2011.137] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To assess learning problems among kindergarten students with extremely preterm birth and to identify risk factors. DESIGN Cohort study. SETTING Children's hospital. PARTICIPANTS A cohort of 148 children born between January 1, 2001, and December 31, 2003, with extremely preterm birth, defined as less than 28 weeks' gestation or having a birth weight of less than 1000 g, and 111 classmate control individuals born at term with normal birth weight. INTERVENTIONS The children were enrolled in the study during their first year in kindergarten and were assessed on measures of learning progress. MAIN OUTCOME MEASURES Achievement testing, teacher ratings of learning progress, and individual educational assistance. RESULTS Children with extremely preterm birth had lower mean standard scores than controls on achievement tests of spelling (8.52; 95% confidence interval, 4.58-12.46) and applied mathematics (11.02; 6.76-15.28). They had higher rates of substandard learning progress by teacher report in written language (odds ratio, 4.23; 95% CI, 2.32-7.73) and mathematics (7.08; 2.79-17.95). Group differences in mathematics achievement and in teacher ratings of learning progress were statistically significant even in children without neurosensory deficits or low global cognitive ability. Neonatal risk factors, early childhood neurodevelopmental impairment, and socioeconomic status predicted learning problems in children with extremely preterm birth; however, many children with problems were not enrolled in a special education program. CONCLUSIONS Learning problems in children with extremely preterm birth are evident in kindergarten and are associated with neonatal and early childhood risk factors. Our findings support efforts to provide more extensive monitoring and interventions before and during the first year of school.
Collapse
Affiliation(s)
- H Gerry Taylor
- Department of Pediatrics, Case Western Reserve University, Rainbow Babies & Children's Hospital, University Hospitals Case Medical Center, Cleveland, OH 44106-6038, USA.
| | | | | | | | | | | |
Collapse
|
33
|
Lagatta J, Andrews B, Caldarelli L, Schreiber M, Plesha-Troyke S, Meadow W. Early neonatal intensive care unit therapy improves predictive power for the outcomes of ventilated extremely low birth weight infants. J Pediatr 2011; 159:384-391.e1. [PMID: 21429509 DOI: 10.1016/j.jpeds.2011.02.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 12/21/2010] [Accepted: 02/07/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the predictive value of early therapy for ventilated extremely low birth weight (ELBW) infants beyond information available at delivery. STUDY DESIGN Prospective, single-center cohort analysis of 177 ventilated ELBW infants. We collected information known at delivery (gestational age, birth weight, singleton, sex, antenatal steroids) and additional information while infants were mechanically ventilated (head ultrasound scanning, clinician intuitions of death before discharge). An adverse outcome was defined as mortality or Bayley Mental Developmental Index or Psychomotor Developmental Index <70 at 2 years. We compared the predictive ability of clinical variables separately, in combination, and in addition to information available at delivery. RESULTS A total of 77% of infants survived to follow-up; 56% of survivors had Bayley Mental Developmental Index and Psychomotor Developmental Index ≥ 70. A total of 95% of infants with both abnormal head ultrasound scanning results and predicted death before discharge had an adverse outcome, independent of gestational age. Conversely, 40% of infants with normal head ultrasound scanning results and no predicted death before discharge had an adverse outcome, independent of gestational age. After adjusting for variables known at birth, predicted death before discharge and abnormal head ultrasound scanning results added significantly to the ability to predict outcomes. CONCLUSION Information gained early in the neonatal intensive care unit improves prediction of mortality or neurodevelopmental impairment in ventilated ELBW infants beyond information available in the delivery room.
Collapse
Affiliation(s)
- Joanne Lagatta
- Department of Pediatrics, University of Chicago, Chicago, IL, USA.
| | | | | | | | | | | |
Collapse
|
34
|
Ford RM, Neulinger K, O'Callaghan M, Mohay H, Gray P, Shum D. Executive Function in 7-9-Year-Old Children Born Extremely Preterm or with Extremely Low Birth Weight: Effects of Biomedical History, Age at Assessment, and Socioeconomic Status. Arch Clin Neuropsychol 2011; 26:632-44. [PMID: 21816952 DOI: 10.1093/arclin/acr061] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ruth M Ford
- School of Psychology and Behavioural Basis of Health Program, Griffith Health Institute, Griffith University, Brisbane, Queensland, Australia
| | | | | | | | | | | |
Collapse
|
35
|
Patrianakos-Hoobler AI, Marks JD, Msall ME, Huo D, Schreiber MD. Safety and efficacy of inhaled nitric oxide treatment for premature infants with respiratory distress syndrome: follow-up evaluation at early school age. Acta Paediatr 2011; 100:524-8. [PMID: 21054515 DOI: 10.1111/j.1651-2227.2010.02077.x] [Citation(s) in RCA: 9] [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: 12/27/2022]
Abstract
AIMS The aims of the study were to assess the long-term safety and compare neurodevelopmental outcomes in school-age children born prematurely who received inhaled nitric oxide or placebo during the first week of life in a randomized, double-blinded study. Children treated with inhaled nitric oxide had previously been shown to have decreased intraventricular haemorrhage and periventricular leukomalacia as newborns and decreased cognitive impairment at 2 years (L.W. Doyle and P.J. Anderson. (2005) Arch Dis Child Fetal Neonatal Ed, 90, F484-F8). METHODS It is follow-up study of medical outcomes, neurodevelopmental assessment and school readiness in 135 of 167 (81%) surviving premature infants seen at 5.7±1.0 years. RESULTS Compared to placebo-treated children (n=65), iNO-treated children (n=70) demonstrated no difference in growth parameters, school readiness or need for subsequent hospitalization. However, iNO-treated children were less likely to have multiple chronic morbidities or technology dependence (p=0.05). They also had less functional disability (p=0.05). CONCLUSION These results demonstrate the long-term safety of iNO in premature infants. Furthermore, iNO treatment may improve health status by decreasing the incidence of severe ongoing morbidities and technology dependence and may also decrease the incidence of educational and community functional disability of premature infants at early school age.
Collapse
|
36
|
Marcello KR, Stefano JL, Lampron K, Barrington KJ, Mackley AB, Janvier A. The influence of family characteristics on perinatal decision making. Pediatrics 2011; 127:e934-9. [PMID: 21444597 DOI: 10.1542/peds.2009-3010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine whether parental characteristics affect estimates of best interests and intervention decisions for preterm infants. DESIGN AND METHODS The study consisted of an anonymous questionnaire given to nurses, physicians, and students. The study included scenarios of 3 sets of parents, including a 16-year-old teenager, a couple who were lawyers, and a couple with a history of in vitro fertilization, about to deliver at 22 5/7 weeks, 24 weeks, or 27 5/7 weeks. Respondents were asked whether active intervention is in the infant's best interests and whether they would comply with family decisions. RESULTS A total of 1105 questionnaires were sent out, with 829 respondents in Canada and the United States. At 22 5/7 weeks' gestation, 21% of the respondents thought that resuscitation was in the infant's best interest; among respondents who did not agree, 59% would intervene if the parents wished. At 27 5/7 weeks' gestation, 95% of respondents thought that resuscitation was in the infant's best interest, yet 34% would accept comfort care. Estimates of best interest, and willingness to comply, varied significantly by parental characteristics. At 22 5/7 weeks' gestation, 17% of respondents believed that resuscitation was in the best interest of the teenaged mother's infant compared with 26% of respondents who believed that resuscitation was in the best interest for the infants of the others; this difference persisted at 24 weeks. At 22 5/7 and at 24 weeks' gestation, compliance with active care despite believing that it not in the infant's best interest was significantly more frequent for the in vitro fertilization couple and the lawyers than for the teenaged mother. At 27 weeks' gestation, more than 93% of respondents complied for all parents. CONCLUSIONS Caregivers frequently are ready to intervene actively, or not, despite believing that it is against the infant's best interest. Willingness to do so varies according to parental characteristics.
Collapse
|
37
|
High rates of school readiness difficulties at 5 years of age in very preterm infants compared with term controls. J Dev Behav Pediatr 2011; 32:117-24. [PMID: 21169858 DOI: 10.1097/dbp.0b013e318206d5c9] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE School readiness is best understood as a framework for assessing profiles of strengths and vulnerabilities of the preschool-age child. Very preterm (VPT) children are at high risk of difficulties in school, and understanding their school readiness skills has the potential to aid successful transition into school. The aim of this study was to determine the school readiness skills of a cohort of VPT children, compared with term controls. METHODS VPT children (gestational age <30 wk or birth weights <1250 g) and term controls were enrolled from a tertiary maternity hospital, Melbourne, Australia into a prospective cohort study. At age 5 years, school readiness skills were evaluated using a combination of parent questionnaires and direct assessments. The 5 domains of school readiness assessed were health and physical development, social-emotional skills, approaches to learning, communication skills, and cognitive skills. RESULTS VPT children had standard scores ~½ to 1 SD below those of the term controls in all domains of school readiness, and these differences were not greatly affected by adjustment for social risk differences. Overall, 44% of the VPT group had vulnerabilities in more than 1 domain of school readiness, compared with only 16% of the term controls. CONCLUSIONS VPT children are more likely than term controls to have significant vulnerabilities in multiple domains of school readiness, and these differences are mostly independent of social risk.
Collapse
|
38
|
McManus BM, Robert SA, Albanese A, Sadek-Badawi M, Palta M. Relationship between neighborhood disadvantage and social function of Wisconsin 2- and 3-year-olds born at very low birth weight. ACTA ACUST UNITED AC 2010; 165:119-25. [PMID: 20921342 DOI: 10.1001/archpediatrics.2010.185] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To examine whether (1) neighborhood disadvantage is associated with social function in 2- and 3-year-olds born at very low birth weight (<1500 g) and (2) the association between social function and child's health-related quality of life (HRQoL) is moderated by neighborhood disadvantage. DESIGN Cross-sectional study using the Newborn Lung Project, a cohort of infants born at very low birth weight in 2003 and 2004 in Wisconsin. SETTING Wisconsin. PARTICIPANTS This study includes the subgroup of 626 non-Hispanic black or white infants who were followed up at ages 24 to 43 months with parent-reported health and developmental information. MAIN EXPOSURE An index of neighborhood disadvantage was derived by principal component analysis of 5 census tract variables (percentage of families in poverty, percentage of households with income higher than the state median, percentage of women with bachelor's degree or more, percentage of single mothers, and percentage of mothers of young children unemployed). Children were then classified (based on index tertiles) as living in either disadvantaged, middle advantage, or advantaged neighborhoods. Children's HRQoL was measured using the Pediatric Quality of Life Inventory. MAIN OUTCOME MEASURE Social function was measured using the Pediatric Evaluation of Disability Inventory. RESULTS Adjusting for child medical and family socioeconomic attributes, social function was lower (mean difference, -4.60; 95% confidence interval, -8.4 to -0.8) for children living in disadvantaged vs advantaged neighborhoods. We also found that the ill effects of lower HRQoL are particularly bad for children living in a disadvantaged neighborhood. CONCLUSION Children born at very low birth weight have disparities in social function at ages 2 and 3 years that are associated with both HRQoL and neighborhood characteristics.
Collapse
Affiliation(s)
- Beth Marie McManus
- School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA.
| | | | | | | | | |
Collapse
|