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Diniz LPM, Cavalcante TCF, da Silva AAM. Comparative Analysis of the GH/IGF-1 Axis during the First Sixth Months in Children with Low Birth Weight. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1842. [PMID: 38136045 PMCID: PMC10741521 DOI: 10.3390/children10121842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/03/2023] [Accepted: 11/14/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE To analyze the relation between alterations in the growth hormone (GH)/insulin-like growth factor 1 (IGF-1) axis during the first 6 months of life and weight in children born in the lower-middle São Francisco region. METHODS This is an analytical cohort and exploratory. Thirty children, were formed two groups, one of low birth weight children (LBW, n = 15) and another of normal weight (NBW = 15) were initially identified in a hospital and reapproached at 3 and 6 months of age. Birth weight and alterations in GH/IGF-1 curves were measured at birth and the third and sixth months of life. RESULTS Weight gain during the 6 months of follow-up in newborns with a low birth weight was greater compared to newborns with a normal birth weight. All children who were born with a low birth weight had an altered GH/IGF-1 curve at birth (p = 0.002). Most newborns with a low birth weight maintained the alteration in the GH/IGF-1 curve at the third month of life (p = 0.027). Regarding the GH/IGF-1 curve at the sixth month, alteration persisted in greater proportion among children with a low birth weight. CONCLUSIONS Alterations in insulin resistance markers, demonstrated by increased GH without a proportional increase in IGF-1, were observed to be significant in children with a low birth weight with greater adiposity in this group which may increase the risk of metabolic diseases in later life.
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Affiliation(s)
- Luciana Pessoa Maciel Diniz
- Colegiado de Enfermagem Campus Petrolina, Universidade de Pernambuco, Petrolina 56328-900, PE, Brazil;
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife 50100-130, PE, Brazil;
| | - Taisy Cinthia Ferro Cavalcante
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife 50100-130, PE, Brazil;
| | - Amanda Alves Marcelino da Silva
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife 50100-130, PE, Brazil;
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Ashorn P, Ashorn U, Muthiani Y, Aboubaker S, Askari S, Bahl R, Black RE, Dalmiya N, Duggan CP, Hofmeyr GJ, Kennedy SH, Klein N, Lawn JE, Shiffman J, Simon J, Temmerman M. Small vulnerable newborns-big potential for impact. Lancet 2023; 401:1692-1706. [PMID: 37167991 DOI: 10.1016/s0140-6736(23)00354-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/27/2023] [Accepted: 02/14/2023] [Indexed: 05/13/2023]
Abstract
Despite major achievements in child survival, the burden of neonatal mortality has remained high and even increased in some countries since 1990. Currently, most neonatal deaths are attributable to being born preterm, small for gestational age (SGA), or with low birthweight (LBW). Besides neonatal mortality, these conditions are associated with stillbirth and multiple morbidities, with short-term and long-term adverse consequences for the newborn, their families, and society, resulting in a major loss of human capital. Prevention of preterm birth, SGA, and LBW is thus critical for global child health and broader societal development. Progress has, however, been slow, largely because of the global community's failure to agree on the definition and magnitude of newborn vulnerability and best ways to address it, to frame the problem attractively, and to build a broad coalition of actors and a suitable governance structure to implement a change. We propose a new definition and a conceptual framework, bringing preterm birth, SGA, and LBW together under a broader umbrella term of the small vulnerable newborn (SVN). Adoption of the framework and the unified definition can facilitate improved problem definition and improved programming for SVN prevention. Interventions aiming at SVN prevention would result in a healthier start for live-born infants, while also reducing the number of stillbirths, improving maternal health, and contributing to a positive economic and social development in the society.
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Affiliation(s)
- Per Ashorn
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Paediatrics, Tampere University Hospital, Tampere, Finland.
| | - Ulla Ashorn
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Yvonne Muthiani
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | | | - Rajiv Bahl
- Indian Council for Medical Research, New Delhi, India
| | - Robert E Black
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Nita Dalmiya
- United Nations Children's Fund, New York, NY, USA
| | - Christopher P Duggan
- Center for Nutrition, Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - G Justus Hofmeyr
- Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana; Effective Care Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Department of Obstetrics and Gynaecology, Walter Sisulu University, East London, South Africa
| | - Stephen H Kennedy
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Nigel Klein
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Jeremy Shiffman
- Paul H Nitze School of Advanced International Studies, Johns Hopkins University, Baltimore, MD, USA
| | | | - Marleen Temmerman
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
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Tseng WL, Chen CH, Chang JH, Peng CC, Jim WT, Lin CY, Hsu CH, Liu TY, Chang HY. Risk Factors of Language Delay at Two Years of Corrected Age among Very-Low-Birth-Weight Preterm Infants: A Population-Based Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020189. [PMID: 36832318 PMCID: PMC9955016 DOI: 10.3390/children10020189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/21/2023]
Abstract
Language delays are often underestimated in very-low-birth-weight (VLBW) preterm infants. We aimed to identify the risk factors of language delay at two years of corrected age in this vulnerable population. VLBW infants, who were assessed at two years of corrected age using the Bayley Scale of Infant Development, third edition, were included using a population-based cohort database. Language delay was defined as mild to moderate if the composite score was between 70 and 85 and severe if the score was < 70. Multivariable logistic regression analysis was used to identify the perinatal risk factors associated with language delay. The study comprised 3797 VLBW preterm infants; 678 (18%) had a mild to moderate delay and 235 (6%) had a severe delay. After adjusting for confounding factors, low maternal education level, low maternal socioeconomic status, extremely low birth weight, male sex, and severe intraventricular hemorrhage (IVH) and/or cystic periventricular leukomalacia (PVL) were found to be significantly associated with both mild to moderate and severe delays. Resuscitation at delivery, necrotizing enterocolitis, and patent ductus arteriosus requiring ligation showed significant associations with severe delay. The strongest factors predicting both mild to moderate and severe language delays were the male sex and severe IVH and/or cystic PVL; thus, early targeted intervention is warranted in these populations.
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Affiliation(s)
- Wei-Lun Tseng
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104217, Taiwan
| | - Chia-Huei Chen
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104217, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City 251020, Taiwan
| | - Jui-Hsing Chang
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104217, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City 251020, Taiwan
| | - Chun-Chih Peng
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104217, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City 251020, Taiwan
| | - Wai-Tim Jim
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104217, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City 251020, Taiwan
| | - Chia-Ying Lin
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104217, Taiwan
| | - Chyong-Hsin Hsu
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104217, Taiwan
| | - Tzu-Yu Liu
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu City 30046, Taiwan
| | - Hung-Yang Chang
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104217, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City 251020, Taiwan
- Correspondence: ; Tel.: +886-2543-3535; Fax: +886-2523-2448
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Monitoring of the auditory pathway maturation after early intervention during the first year of life in infants with sensorineural hearing loss. Eur Arch Otorhinolaryngol 2020; 278:4187-4197. [PMID: 33336301 PMCID: PMC8486705 DOI: 10.1007/s00405-020-06498-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/11/2020] [Indexed: 11/17/2022]
Abstract
Purpose The objective of this study was to investigate the auditory pathway maturation monitored by auditory brainstem responses (ABR) in infants with hearing loss during the first year of life. ABR were used to estimate hearing thresholds and the effect of early intervention strategies using hearing aids (HA). Methods Click-evoked ABRs were measured in 102 infants aged from 0 to 12 months to determine their individual auditory threshold. Early therapy intervention was recommended before 12 months of age and analyzed. To evaluate the effect of hearing amplification on auditory maturation, different subgroups of infants with moderate hearing loss were analyzed and the auditory pathway maturation was determined based on IPL I–V shortening. Results Overall, 110 ears (54.0% of 204 ears) with mild to profound HL showed threshold changes of 10 dB up to 60 dB in the follow-up ABR testing. HA were prescribed at the age of 3.8 ± 3.9 months. Cochlear implantation (CI) was performed in cases of repeated profound HL at the age of 9.9 months ± 4.5 months. A significant shortening of IPL I–V in all subgroups of infants (with and without risk factors) who received HA was shown and assumed auditory pathway maturation. Conclusion An early intervention using optimally fitted HA influenced auditory pathway maturation and may lead to improvements of hearing thresholds during the first year of life in infants. This study underscores the importance of not only providing HAs to infants, but also controlling for hearing threshold changes ensuring that HAs provide the optimal level of intervention or CI is indicated.
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Antinmaa J, Lapinleimu H, Salonen J, Stolt S, Kaljonen A, Jääskeläinen S. Neonatal brainstem auditory function associates with early receptive language development in preterm children. Acta Paediatr 2020; 109:1387-1393. [PMID: 31833585 PMCID: PMC7317215 DOI: 10.1111/apa.15136] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/02/2019] [Accepted: 12/10/2019] [Indexed: 11/26/2022]
Abstract
AIM To study whether auditory function measured with brainstem auditory evoked potential and brainstem audiometry recordings in the neonatal period associates with language development 1 year later in preterm infants. METHODS This retrospective study included 155 preterm infants (birthweight ≤1500 g and/or birth ≤32 gestational weeks) born between 2007 and 2012 at the Turku University Hospital. Auditory function was recorded in neonatal period. Information of language development was gathered at the mean corrected age of 1 year by using the Finnish version of the MacArthur Communicative Development Inventory. RESULTS Slower auditory processing (longer interpeak interval, IPI I-V) in the right ear in the neonatal brainstem auditory evoked potential recording associated with smaller receptive lexicon size at 1 year (P = .043). Infants with longer IPI I-V were more likely to have a deviant (≤17 words) receptive lexicon size (P = .033). The absence of a contralateral response with right ear stimulation increased the risk for deviant lexicon size (P = .049). CONCLUSION The results suggest that impaired auditory function in the neonatal period in preterm infants may lead to a poorer receptive language outcome 1 year later. Auditory pathway function assessment provides information for the identification of preterm children at risk for weak language development.
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Affiliation(s)
- Jaana Antinmaa
- Department of Clinical Neurophysiology Turku University Hospital and University of Turku Turku Finland
- Department of Pediatrics and Adolescent Medicine Turku University Hospital and University of Turku Turku Finland
- Department of Pediatrics The Hospital District of South Ostrobothnia Seinäjoki Finland
| | - Helena Lapinleimu
- Department of Pediatrics and Adolescent Medicine Turku University Hospital and University of Turku Turku Finland
| | - Jaakko Salonen
- Department of Otorhinolaryngology Turku University Hospital Turku Finland
| | - Suvi Stolt
- Department of Psychology and Speech and Language Pathology (Logopedics) Faculty of Medicine University of Helsinki Helsinki Finland
| | - Anne Kaljonen
- Department of Biostatistics Faculty of Medicine University of Turku Turku Finland
| | - Satu Jääskeläinen
- Department of Clinical Neurophysiology Turku University Hospital and University of Turku Turku Finland
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Gouveia ASD, Oliveira MMDF, Goulart AL, Azevedo MFD, Perissinoto J. Development of speech and hearing skills in prematures adequate and small for gestational age: chronological age between 18 and 36 months. Codas 2020; 32:e20180275. [PMID: 32049103 DOI: 10.1590/2317-1782/20192018275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 08/19/2019] [Indexed: 11/22/2022] Open
Abstract
PURPOSE This study aimed to identify whether the development of hearing abilities in the first year of life is related to the development of language in preterm neonates with chronological age between 18 and 36 months, verifying if the language performance varies according to the weight/gestational age ratio. METHODS Retrospective and longitudinal study approved by the Institution's Ethics Committee. The sample consisted of 66 preterm infants of both sexes, aged 18-36 months, divided into two groups: AIG Group 39 neonates with weight appropriate to the gestational age, 26 with normal hearing and 13 with altered hearing; and PIG group 27 neonates small for gestational age, 18 with normal and 9 with altered hearing. Results from the development of auditory skills in the first year of life and evaluation of the reception, expression and total of language (Menezes, 2003) were obtained from neonatal follow-up records. We used the ANOVA and the Equality Test of Two Proportions as statistical procedures. RESULTS In each group, we observed a significant difference in the Reception and Total language in children with normal and altered auditory development. Children with normal hearing development presented a higher percentage of language adequacy. The language performance did not differ in relation to the weight / gestational age adequacy. CONCLUSION Changing auditory abilities in the first year of life interfered more in language development than the gestational age / weight ratio.
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Affiliation(s)
| | | | - Ana Lúcia Goulart
- Escola Paulista de Medicina - EPM, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brasil
| | - Marisa Frasson de Azevedo
- Escola Paulista de Medicina - EPM, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brasil
| | - Jacy Perissinoto
- Escola Paulista de Medicina - EPM, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brasil
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Belanger R, Leroux D, Lefebvre P. Supporting caregivers of children born prematurely in the development of language: A scoping review. Paediatr Child Health 2019; 26:e17-e24. [PMID: 33542775 DOI: 10.1093/pch/pxz124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 07/08/2019] [Indexed: 11/13/2022] Open
Abstract
Background Infants born prematurely can display impairments that negatively impact the early years of their development. Compared to their peers born at term, preterm children have higher risks of cerebral palsy, sensory deficits, learning disabilities, cognitive and language deficits, as well as difficulties related to attention and behaviour. Following discharge, parents of preterm children are often supported through neonatal follow-up programs or by community health care practitioners. Through assessment and consultation, professionals foster parental resilience by teaching them about their child's development. Research shows a large volume of literature on improving outcomes for preterm infants, but less attention has been given to the impact and potential importance of education of parents regarding the care they provide from the home. Objective A scoping review was completed to determine the best practices for early intervention in premature children regarding the development of language skills during the preschool years. Methods The review followed the guidelines for the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Results Four general themes emerged from the review and included the importance of providing (1) parental training in the care of an infant born prematurely during neonatal intensive care unit stay; (2) education on the development of language and the importance of parental responsiveness; (3) provision of activities to support child language learning; and (4) overall and ongoing monitoring and support by qualified health professionals. Conclusions The conclusions drawn will provide guidance to health care professionals regarding the education of parents on best practices for stimulating language development in their child.
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Affiliation(s)
- Roxanne Belanger
- School of Speech-Language Pathology, Laurentian University, Sudbury, Ontario
| | - Dominique Leroux
- School of Speech-Language Pathology, Laurentian University, Sudbury, Ontario
| | - Pascal Lefebvre
- School of Speech-Language Pathology, Laurentian University, Sudbury, Ontario
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Fernandez-Macias R, Martinez-Portilla RJ, Cerrillos L, Figueras F, Palacio M. A systematic review and meta-analysis of randomized controlled trials comparing 17-alpha-hydroxyprogesterone caproate versus placebo for the prevention of recurrent preterm birth. Int J Gynaecol Obstet 2019; 147:156-164. [PMID: 31402445 DOI: 10.1002/ijgo.12940] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 03/29/2019] [Accepted: 08/09/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Preterm birth causes an increased risk for perinatal morbidity and mortality. OBJECTIVE To determine whether mid-trimester 17-alpha-hydroxyprogesterone caproate (17-OHPC) reduces the risk of recurrent preterm birth and adverse perinatal outcomes. SEARCH STRATEGY Systematic search to identify relevant studies published in different languages, registered after 2000, using appropriate MeSH terms. SELECTION CRITERIA Inclusion criteria were women between 16 and 26+6 weeks of pregnancy with history of preterm delivery in any pregnancy randomized to either 17-OHPC or placebo/no treatment. DATA COLLECTION AND ANALYSIS The number of preterm births and adverse outcomes in the 17-OHPC and placebo arms over the total number of patients in each randomized group were used to calculate the risk ratio (RR) by random-effects models using the Mantel-Haenszel method. Between-study heterogeneity was assessed using tau2 , χ2 (Cochrane Q), and I2 statistics. MAIN RESULTS Four studies were included. There was a 29% (RR 0.71; 95% CI, 0.53-0.96; P=0.001), 26% (RR 0.74; 95% CI, 0.58-0.96; P=0.021), and 40% (RR 0.60; 95% CI, 0.42-0.85; P=0.004) reduction in recurrent preterm birth at <37, <35, and <32 weeks, respectively, in the 17-OHPC group compared with placebo. The reduction in neonatal death was 68% (RR 0.32; 95% CI, 0.15-0.66; P=0.002). CONCLUSIONS 17-OHPC could reduce the risk of recurrent preterm birth at <37, <35, and <28 weeks and neonatal death. PROSPERO CDR42017082190.
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Affiliation(s)
- Rosa Fernandez-Macias
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut Clínic de Ginecologia, Obstetricia i Neonatologia, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Department of Genetics, Reproduction and Maternal-Fetal Medicine, University Hospital Virgen del Rocío, Seville, Spain
| | - Raigam J Martinez-Portilla
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut Clínic de Ginecologia, Obstetricia i Neonatologia, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Maternal-Fetal Medicine and Therapy Research Center Mexico; on behalf of the Iberoamerican Research Network in Translational, Molecular and Maternal-Fetal Medicine, Mexico City, Mexico
| | - Lucas Cerrillos
- Department of Genetics, Reproduction and Maternal-Fetal Medicine, University Hospital Virgen del Rocío, Seville, Spain
| | - Francesc Figueras
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut Clínic de Ginecologia, Obstetricia i Neonatologia, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - Montse Palacio
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut Clínic de Ginecologia, Obstetricia i Neonatologia, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Catalonia, Spain
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Lithoxopoulou M, Rallis D, Christou H, Goutsiou E, Varaklioti A, Karagianni P, Tsakalidis C, Domeyer P, Kuriakeli G, Soubasi V. Early caloric deprivation in preterm infants affects Bayley-III scales performance at 18-24 months of corrected age. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 91:103429. [PMID: 31272067 DOI: 10.1016/j.ridd.2019.103429] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 04/13/2019] [Accepted: 06/22/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Adequate nutrition is essential for optimal neurodevelopment to preterm infants. Our aim was to evaluate the impact of caloric deprivation on Bayley-III scales performance at 18-24 months of corrected age, in a cohort of preterm infants. METHODS We prospectively enrolled infants with gestational age <30 weeks and birth weight <1500 g. Apart from a whole cohort analysis, we performed a subgroup analysis between infants received inadequate calories (<85 Kcal/kg/day) during the first two weeks of age, compared to a standard nutrition group. All infants underwent a Bayley-III assessment at 18-24 months of corrected age. RESULTS From the 63 preterm infants analysed, 25% had caloric deprivation compared to 75% with adequate nutrition. Caloric deprived infants were of lower gestational age and birth weight, and received a lower amount of enteral feeding during the first 14 days of age. There were no differences between the two groups regarding the common neonatal co-morbidities. Caloric deprived infants had significantly lower composite index scores at 18-24 months of corrected age. Caloric deprivation, late onset sepsis, necrotizing enterocolitis, and bronchopulmonary dysplasia were significant risk factors of neurodevelopmental impairment. CONCLUSIONS Several neonatal factors affect the neurodevelopmental outcome of preterm infants, and nutrition may pose an important role.
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Affiliation(s)
- Maria Lithoxopoulou
- 2nd Department of Neonatology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Rallis
- 2nd Department of Neonatology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Helen Christou
- Brigham and Women's Hospital and Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Evanthia Goutsiou
- 2nd Department of Neonatology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Agoritsa Varaklioti
- Faculty of Social Sciences, Department of Health Management, Hellenic Open University, Patras, Greece
| | - Paraskevi Karagianni
- 2nd Department of Neonatology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Tsakalidis
- 2nd Department of Neonatology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Philip Domeyer
- Faculty of Social Sciences, Department of Health Management, Hellenic Open University, Patras, Greece
| | - Georgia Kuriakeli
- 2nd Department of Neonatology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki Soubasi
- 2nd Department of Neonatology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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White-Traut RC, Rankin KM, Yoder J, Zawacki L, Campbell S, Kavanaugh K, Brandon D, Norr KF. Relationship between mother-infant mutual dyadic responsiveness and premature infant development as measured by the Bayley III at 6 weeks corrected age. Early Hum Dev 2018; 121:21-26. [PMID: 29730131 PMCID: PMC8656267 DOI: 10.1016/j.earlhumdev.2018.04.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 04/22/2018] [Accepted: 04/23/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND The quality of mother-preterm infant interaction has been identified as a key factor in influencing the infant's later development and language acquisition. The relationship between mother-infant responsiveness and later development may be evident early in infancy, a time period which has been understudied. AIM Describe the relationship between mother-infant mutual dyadic responsiveness and premature infant development. DESIGN This study employed a secondary analysis of data from the 6-week corrected age (CA) follow-up visit of the Hospital-Home Transition: Optimizing Prematures' Environment (H-HOPE) study, a randomized clinical trial testing the efficacy of a mother- and infant- focused intervention for improving outcomes among premature infants. SUBJECTS Premature infants born between 29 and 34 weeks gestational age and their mothers who had social-environmental risks. OUTCOME MEASURES At 6-weeks corrected age, a play session was coded for the quality of mutual responsiveness (Dyadic Mutuality Code). Development was assessed via the Bayley Scales of Infant and Toddler Development, 3rd edition. RESULTS Of 137 mother-infant dyads, high, medium and low mutual responsiveness was observed for 35.8%, 34.3% and 29.9%, respectively. Overall motor, language and cognitive scores were 115.8 (SD = 8.2), 108.0 (7.7) and 109.3 (7.9). Multivariable linear models showed infants in dyads with high versus low mutual responsiveness had higher scores on the motor (β = 3.07, p = 0.06) and language (β = 4.47, p = 0.006) scales. CONCLUSION High mutual responsiveness in mother-premature infant dyads is associated with significantly better language development and marginally better motor development.
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Affiliation(s)
- Rosemary C White-Traut
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, College of Nursing, 845 South Damen Avenue, Chicago, IL 60612, United States; Children's Hospital of Wisconsin, Children's Corporate Center, P. O. Box 1997, MSC 140, Milwaukee, WI 53201-1997, United States.
| | - Kristin M Rankin
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, Chicago, IL 60612, United States
| | - Joe Yoder
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, College of Nursing, 845 South Damen Avenue, Chicago, IL 60612, United States
| | - Laura Zawacki
- Department of Physical and Occupational Therapy, University of Illinois Hospital and Health Sciences System, 1600 West Taylor Street, Chicago, IL 60612, United States
| | - Suzann Campbell
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, 1919 West Taylor Street, Chicago, IL 60612, United States
| | - Karen Kavanaugh
- Children's Hospital of Wisconsin, Children's Corporate Center, P. O. Box 1997, MSC 140, Milwaukee, WI 53201-1997, United States
| | - Debra Brandon
- Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC 27710, United States
| | - Kathleen F Norr
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, College of Nursing, 845 South Damen Avenue, Chicago, IL 60612, United States
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