1
|
Verberne EA, Lo-A-Njoe SM, van Ginkel M, Zwolsman J, Nikkels S, Clement L, de Vroomen M, Wever MLG, Arends E, Holtsema H, Hajenius PJ, Moreta D, Ecury-Goossen GM, Mannens MMAM, de Walle HEK, Bergman JEH, van Haelst MM. Prevalence of congenital anomalies in the Dutch Caribbean islands of Aruba, Bonaire, and Curaçao. Birth Defects Res 2023; 115:595-604. [PMID: 36757056 DOI: 10.1002/bdr2.2153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/16/2023] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Congenital anomalies represent an important global health issue. Data on the prevalence and pattern of congenital anomalies in the Caribbean region are scarce and lacking altogether in Aruba, Bonaire and Curaçao (ABC islands). METHODS We performed a population-based surveillance study to determine the prevalence of structural congenital anomalies in the ABC islands, including all live births and stillbirths between January 1, 2008 and December 31, 2017 with major congenital anomalies according to EUROCAT guide 1.5. Terminations of pregnancy for fetal anomaly were included as well. Cases were identified by active case ascertainment, using multiple sources including pediatric patient files and discharge letters, delivery records, and clinical genetic patient files. Total and subgroup prevalence rates were compared between the three islands and to the French West Indies and Northern Netherlands. RESULTS Total prevalence of congenital anomalies on the ABC islands was 242.97 per 10,000 births. Total prevalence of congenital anomalies in Bonaire (325.15 per 10,000 births) was higher compared to Aruba (233.29 per 10,000 births) and Curaçao (238.58 per 10,000 births), which was mainly attributable to a higher prevalence of limb anomalies, in particular polydactyly, in Bonaire. Total prevalence of congenital anomalies on the ABC islands was comparable to the French West Indies (248.69 per 10,000 births) but significantly lower compared to the Northern Netherlands (298.98 per 10,000 births). In the subgroup prevalence analysis, the prevalence of polydactyly and atrial septal defect on the ABC islands was significantly higher compared with the French West Indies and the Northern Netherlands, while the prevalence of congenital anomalies of the kidney and urinary tract and genetic disorders was significantly lower. CONCLUSIONS This is the first study to establish the prevalence and pattern of congenital anomalies on the ABC islands, which is important to inform healthcare managers and policymakers and to provide a basis for continuous surveillance of congenital anomalies.
Collapse
Affiliation(s)
- Eline A Verberne
- Department of Human Genetics and Amsterdam Reproduction & Development research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Manon van Ginkel
- Department of Human Genetics and Amsterdam Reproduction & Development research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jet Zwolsman
- Department of Human Genetics and Amsterdam Reproduction & Development research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sylke Nikkels
- Department of Pediatrics, Curaçao Medical Center, Willemstad, Curaçao
- Department of Pediatrics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Lauren Clement
- Department of Human Genetics and Amsterdam Reproduction & Development research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Maartje de Vroomen
- Department of Pediatrics, Fundashon Mariadal, Kralendijk, Bonaire, The Netherlands
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Maria L G Wever
- Department of Pediatrics, Dr. Horacio E. Oduber Hospital, Oranjestad, Aruba
| | - Eric Arends
- Department of Pediatrics, Dr. Horacio E. Oduber Hospital, Oranjestad, Aruba
| | - Hilda Holtsema
- Department of Obstetrics & Gynecology, Curaçao Medical Center, Willemstad, Curaçao
| | - Petra J Hajenius
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynecology, Fundashon Mariadal, Kralendijk, Bonaire, The Netherlands
| | - Daphne Moreta
- Department of Obstetrics and Gynecology, Dr. Horacio E. Oduber Hospital, Oranjestad, Aruba
| | | | - Marcel M A M Mannens
- Department of Human Genetics and Amsterdam Reproduction & Development research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Hermien E K de Walle
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, the Netherlands
| | - Jorieke E H Bergman
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, the Netherlands
| | - Mieke M van Haelst
- Department of Human Genetics and Amsterdam Reproduction & Development research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
2
|
Vanholder IM, Ecury-Goossen GM, Admiraal J, Porcelijn L, van Spaendonk RM, Gouw SC. Congenital amegakaryocytic thrombocytopenia presenting with a new thrombopoietin receptor (MPL) pathogenic variant: An instructive neonatal case. J Paediatr Child Health 2022; 58:2319-2321. [PMID: 35972311 DOI: 10.1111/jpc.16168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/08/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Inez M Vanholder
- Department of Neonatology and Paediatrics, Curaçao Medical Center, J.H.J. Hamelweg, Willemstad, Curaçao.,Department of Paediatrics, University of Antwerp, Edegem, Belgium
| | - Ginette M Ecury-Goossen
- Department of Neonatology and Paediatrics, Curaçao Medical Center, J.H.J. Hamelweg, Willemstad, Curaçao
| | - Jop Admiraal
- Department of Neonatology and Paediatrics, Curaçao Medical Center, J.H.J. Hamelweg, Willemstad, Curaçao.,Department of Paediatrics, University of Amsterdam, Amsterdam, The Netherlands
| | - Leendert Porcelijn
- Immunohematology Diagnostic Services, Sanquin Diagnostic Services, Amsterdam, The Netherlands
| | | | - Samantha C Gouw
- Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
3
|
Verberne EA, Westermann JM, de Vries TI, Ecury-Goossen GM, Lo-A-Njoe SM, Manshande ME, Faries S, Veenhuis HD, Philippi P, Falix FA, Rosina-Angelista I, Ponson-Wever M, Rafael-Croes L, Thorsen P, Arends E, de Vroomen M, Nagelkerke SQ, Tilanus M, van der Veken LT, Huijsdens-van Amsterdam K, van der Kevie-Kersemaekers AM, Alders M, Mannens MMAM, van Haelst MM. Genetic care in geographically isolated small island communities: 8 years of experience in the Dutch Caribbean. Am J Med Genet A 2022; 188:1777-1791. [PMID: 35253369 PMCID: PMC9314971 DOI: 10.1002/ajmg.a.62708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/25/2022] [Accepted: 02/12/2022] [Indexed: 11/16/2022]
Abstract
Worldwide, there are large inequalities in genetic service delivery. In 2011, we established a bi‐annual joint pediatric‐genetics clinic with a visiting clinical geneticist in the Dutch Caribbean. This retrospective study evaluates the yield of diagnostic testing and the clinical utility of a diagnosis for patients with rare diseases on these relatively isolated, resource‐limited islands. A total of 331 patients that were referred to the clinical geneticist between November 2011 and November 2019 and had genetic testing were included in this study. A total of 508 genetic tests were performed on these patients. Microarray, next‐generation sequencing gene panels, and single‐gene analyses were the most frequently performed genetic tests. A molecularly confirmed diagnosis was established in 33% of patients (n = 108). Most diagnosed patients had single nucleotide variants or small insertions and/or deletions (48%) or copy number variants (34%). Molecular diagnostic yield was highest in patients referred for seizures and developmental delay/intellectual disability. The genetic diagnosis had an impact on clinical management in 52% of patients. Referrals to other health professionals and changes in therapy were the most frequently reported clinical consequences. In conclusion, despite limited financial resources, our genetics service resulted in a reasonably high molecular diagnostic yield. Even in this resource‐limited setting, a genetic diagnosis had an impact on clinical management for the majority of patients. Our approach with a visiting clinical geneticist may be an example for others who are developing genetic services in similar settings.
Collapse
Affiliation(s)
- Eline A Verberne
- Department of Human Genetics and Amsterdam Reproduction & Development research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jonne M Westermann
- Department of Human Genetics and Amsterdam Reproduction & Development research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Tamar I de Vries
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Medical Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | | | | | - Sonja Faries
- Department of Pediatrics, Curaçao Medical Center, Willemstad, Curaçao
| | - Hans D Veenhuis
- Department of Pediatrics, Curaçao Medical Center, Willemstad, Curaçao
| | - Patricia Philippi
- Department of Pediatrics, Curaçao Medical Center, Willemstad, Curaçao
| | - Farah A Falix
- Department of Pediatrics, Curaçao Medical Center, Willemstad, Curaçao
| | | | - Maria Ponson-Wever
- Department of Pediatrics, Dr. Horacio E. Oduber Hospital, Oranjestad, Aruba
| | | | - Patricia Thorsen
- Department of Pediatrics, Dr. Horacio E. Oduber Hospital, Oranjestad, Aruba
| | - Eric Arends
- Department of Pediatrics, Dr. Horacio E. Oduber Hospital, Oranjestad, Aruba
| | - Maartje de Vroomen
- Department of Pediatrics, Fundashon Mariadal, Kralendijk, Bonaire, The Netherlands.,Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sietse Q Nagelkerke
- Department of Pediatrics, Fundashon Mariadal, Kralendijk, Bonaire, The Netherlands.,Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Martijn Tilanus
- Department of Pediatrics, St. Maarten Medical Center, Cay Hill, St. Maarten
| | - Lars T van der Veken
- Department of Genetics, Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Karin Huijsdens-van Amsterdam
- Department of Genetics, Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Anne-Marie van der Kevie-Kersemaekers
- Department of Human Genetics and Amsterdam Reproduction & Development research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mariëlle Alders
- Department of Human Genetics and Amsterdam Reproduction & Development research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marcel M A M Mannens
- Department of Human Genetics and Amsterdam Reproduction & Development research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mieke M van Haelst
- Department of Human Genetics and Amsterdam Reproduction & Development research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
4
|
Verberne EA, Ecury-Goossen GM, Manshande ME, Ponson-Wever M, de Vroomen M, Tilanus M, Mannens MMAM, Henneman L, van Haelst MM. Clinical and community genetics services in the Dutch Caribbean. J Community Genet 2021; 12:497-501. [PMID: 33751485 PMCID: PMC7943254 DOI: 10.1007/s12687-021-00515-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/01/2021] [Indexed: 10/26/2022] Open
Abstract
The Caribbean part of the Kingdom of the Netherlands consists of six islands: Aruba, Bonaire, Curaçao, St. Maarten, St. Eustatius, and Saba. Because of their small size and relative remoteness, they face several economic and healthcare challenges, including limited access to genetics services. In this article, we provide an overview of the clinical and community genetics services that are available in the Dutch Caribbean. In particular, we describe our joint pediatric-genetics clinic with a visiting clinical geneticist that was established in 2011 to provide clinical genetics services for the pediatric population of the Dutch Caribbean.
Collapse
Affiliation(s)
- Eline A Verberne
- Department of Clinical Genetics and Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | - Maria Ponson-Wever
- Department of Pediatrics, Dr. Horacio E. Oduber Hospital, Oranjestad, Aruba
| | - Maartje de Vroomen
- Department of Pediatrics, Fundashon Mariadal, Kralendijk, Bonaire, The Netherlands.,Department of Pediatrics, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Martijn Tilanus
- Department of Pediatrics, St. Maarten Medical Center, Cay Hill, St. Maarten
| | - Marcel M A M Mannens
- Department of Clinical Genetics and Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lidewij Henneman
- Department of Clinical Genetics and Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Mieke M van Haelst
- Department of Clinical Genetics and Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. .,Department of Clinical Genetics and Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
| |
Collapse
|
5
|
van Ewijk R, Huibers MHW, Manshande ME, Ecury-Goossen GM, Duits AJ, Calis JC, van Wassenaer-Leemhuis AG. Neurologic sequelae of severe chikungunya infection in the first 6 months of life: a prospective cohort study 24-months post-infection. BMC Infect Dis 2021; 21:179. [PMID: 33593326 PMCID: PMC7885242 DOI: 10.1186/s12879-021-05876-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/08/2021] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Perinatally chikungunya infected neonates have been reported to have high rates of post-infection neurologic sequelae, mainly cognitive problems. In older children and adults chikungunya does not appear to have sequelae, but data on postnatally infected infants are lacking. METHODS We performed a prospective, non-controlled, observational study of infants infected before the age of 6 months with a severe chikungunya infection during the 2014-2015 epidemic in Curaçao, Dutch Antilles. Two years post-infection cognitive and motor - (BSID-III) and social emotional assessments (ITSEA) were performed. RESULTS Of twenty-two infected infants, two died and two were lost to follow up. Eighteen children were seen at follow-up and included in the current study. Of these, 13 (72%) had abnormal scores on the BSID-III (cognitive/motor) or ITSEA. CONCLUSION In the first study aimed at postnatally infected infants, using an uncontrolled design, we observed a very high percentage of developmental problems. Further studies are needed to assess causality, however until these data are available preventive measure during outbreaks should also include young infants. Those that have been infected in early infancy should receive follow up.
Collapse
Affiliation(s)
- Roelof van Ewijk
- Saint Elisabeth Hospital, Willemstad, Curaçao.
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands.
| | - Minke H W Huibers
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Global Child Health Group, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | | | - Ashley J Duits
- Saint Elisabeth Hospital, Willemstad, Curaçao
- Red Cross Blood Bank Foundation Curaçao, Willemstad, Curaçao
| | - Job C Calis
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Global Child Health Group, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | |
Collapse
|
6
|
Hortensius LM, Dijkshoorn ABC, Ecury-Goossen GM, Steggerda SJ, Hoebeek FE, Benders MJNL, Dudink J. Neurodevelopmental Consequences of Preterm Isolated Cerebellar Hemorrhage: A Systematic Review. Pediatrics 2018; 142:peds.2018-0609. [PMID: 30341153 DOI: 10.1542/peds.2018-0609] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2018] [Indexed: 11/24/2022] Open
Abstract
CONTEXT The effect of neonatal cerebellar hemorrhage on neurodevelopmental outcome (NDO) in the absence of supratentorial injury is still largely unknown. OBJECTIVE To evaluate the influence of isolated neonatal cerebellar hemorrhage on cognitive, motor, language, and behavioral NDOs and assess the effect of location and size on outcome. DATA SOURCES Embase, Medline, and Scopus were searched from inception to September 30, 2017. STUDY SELECTION Studies in which a diagnosis of isolated cerebellar hemorrhage was reported in preterm infants (<32 weeks' gestation) with a standardized NDO at ≥12 months of age were included. DATA EXTRACTION Patient characteristics, location, and size of bleeding and NDO (defined as severe [yes or no] on the basis of given cutoff points) in 4 domains were extracted. RESULTS Of the 1519 studies identified, 8 were included in final analyses. Of infants with isolated cerebellar hemorrhage, 128 were described (cumulative incidence: 2.3%). The incidence of severe delay in cognition, motor, language, and behavioral development was 38%, 39%, 41%, and 38%, respectively. The overall incidence of severe neurodevelopmental delay in ≥1 domain ranged from 43% to 75% and was most seen in infants with vermis involvement (87%-93%) and with large bleeds (46%-82%). LIMITATIONS Different neurodevelopmental scales lead to data heterogeneity, and reporting of data on a group level limited possibilities for an outcome description on an individual level. CONCLUSIONS Of infants with isolated cerebellar hemorrhage, 43% to 75% were severely delayed in cognition, motor, language, and/or behavioral development, with the highest incidence with vermis involvement and with large bleeds.
Collapse
Affiliation(s)
| | | | | | - Sylke J Steggerda
- Department of Neonatology, Leiden University Medical Center, Leiden, Netherlands; and
| | - Freek E Hoebeek
- Laboratory of Neuroimmunology and Developmental Origins of Disease, Wilhelmina Children's Hospital and Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Department of Neuroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | | |
Collapse
|
7
|
de Goederen R, Raets MMA, Ecury-Goossen GM, de Jonge RCJ, Ramenghi LA, Koning IV, Govaert P, Dudink J. Effect of Preterm Birth on Echogenicity in Basal Ganglia. Ultrasound Med Biol 2017; 43:2192-2199. [PMID: 28750943 DOI: 10.1016/j.ultrasmedbio.2017.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/06/2017] [Accepted: 06/16/2017] [Indexed: 06/07/2023]
Abstract
In this study, the influence of prematurity on echogenicity of deep gray matter at 30-wk corrected age was assessed using ultrasound measurements. In an observational cohort study, ultrasound scans of 224 extremely preterm infants were prospectively collected. Gray values were assessed in putamen and globus pallidus. Intra- and inter-observer reliability was analyzed and showed excellent agreement. The globus pallidus to putamen ratio was significantly related to gestational age at birth, adjusted regression coefficient in points per wk: 1.28 (95% confidence interval [CI]: 0.38-2.19) for left and 2.12 (95% CI: 1.23-3.02) for right-side images. At 30-wk corrected age this was still the case, adjusted regression coefficient: 0.45 (95% CI: -0.57 to 1.47) for left and 1.29 (95% CI: 0.10-2.48) for right. The putamen is more hyperechoic with lower gestational age. Measuring ultrasound gray values in deep gray matter seems highly reproducible. Prematurity shows a negative correlation with echogenicity of the putamen, this persists at 30-wk corrected age, suggesting altered maturation.
Collapse
Affiliation(s)
- Robbin de Goederen
- Department of Pediatrics, Division of Neonatology Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Marlou M A Raets
- Department of Pediatrics, Division of Neonatology Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Ginette M Ecury-Goossen
- Department of Pediatrics, Division of Neonatology Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Rogier C J de Jonge
- Department of Pediatrics, Division of Neonatology Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Luca A Ramenghi
- Department of Neonatology, Istituto Giannina Gaslini, Genoa, Italy
| | - Irene V Koning
- Department of Obstetrics, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Paul Govaert
- Department of Pediatrics, Division of Neonatology Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Neonatology, Koningin Paola Children's Hospital, Antwerp, Belgium
| | - Jeroen Dudink
- Department of Pediatrics, Division of Neonatology Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Neonatology, UMCU Wilhelmina Children's Hospital, Utrecht, The Netherlands.
| |
Collapse
|
8
|
Koning IV, Tielemans MJ, Hoebeek FE, Ecury-Goossen GM, Reiss IKM, Steegers-Theunissen RPM, Dudink J. Impacts on prenatal development of the human cerebellum: a systematic review. J Matern Fetal Neonatal Med 2016; 30:2461-2468. [PMID: 27806674 DOI: 10.1080/14767058.2016.1253060] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE The cerebellum is essential for normal neurodevelopment and is particularly susceptible for intra-uterine disruptions. Although some causal prenatal exposures have been identified, the origin of neurodevelopmental disorders remains mostly unclear. Therefore, a systematic literature search was conducted to provide an overview of parental environmental exposures and intrinsic factors influencing prenatal cerebellar growth and development in humans. MATERIALS AND METHODS The literature search was limited to human studies in the English language and was conducted in Embase, Medline, Cochrane, Web of Science, Pubmed and GoogleScholar. Eligible studies were selected by three independent reviewers and study quality was scored by two independent reviewers. RESULTS The search yielded 3872 articles. We found 15 eligible studies reporting associations between cerebellar development and maternal smoking (4), use of alcohol (3), in vitro fertilization mediums (1), mercury (1), mifepristone (2), aminopropionitriles (1), ethnicity (2) and cortisol levels (1). No studies reported on paternal factors. CONCLUSIONS Current literature on associations between parental environmental exposures, intrinsic factors and human cerebellar development is scarce. Yet, this systematic review provided an essential overview of human studies demonstrating the vulnerability of the cerebellum to the intra-uterine environment.
Collapse
Affiliation(s)
- Irene V Koning
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Rotterdam , The Netherlands.,b Department of Pediatrics , Subdivision of Neonatology, Sophia Children's Hospital , Rotterdam , The Netherlands
| | | | - Freek E Hoebeek
- d Department of Neuroscience , Erasmus MC University Medical Center , Rotterdam , The Netherlands , and
| | - Ginette M Ecury-Goossen
- b Department of Pediatrics , Subdivision of Neonatology, Sophia Children's Hospital , Rotterdam , The Netherlands
| | - Irwin K M Reiss
- b Department of Pediatrics , Subdivision of Neonatology, Sophia Children's Hospital , Rotterdam , The Netherlands
| | - Regine P M Steegers-Theunissen
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Rotterdam , The Netherlands.,b Department of Pediatrics , Subdivision of Neonatology, Sophia Children's Hospital , Rotterdam , The Netherlands
| | - Jeroen Dudink
- b Department of Pediatrics , Subdivision of Neonatology, Sophia Children's Hospital , Rotterdam , The Netherlands.,e Department of Neonatology , Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht , The Netherlands
| |
Collapse
|
9
|
Ecury-Goossen GM, Raets MMA, Camfferman FA, Vos RHJ, van Rosmalen J, Reiss IKM, Govaert P, Dudink J. Resistive indices of cerebral arteries in very preterm infants: values throughout stay in the neonatal intensive care unit and impact of patent ductus arteriosus. Pediatr Radiol 2016; 46:1291-300. [PMID: 27259991 PMCID: PMC4943974 DOI: 10.1007/s00247-016-3615-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 02/13/2016] [Accepted: 03/18/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Little is known about cerebral artery resistive index values in infants born extremely preterm. OBJECTIVE To report resistive index values in various cerebral arteries in a prospective cohort of preterm infants born at <29 weeks' gestation, and to compare resistive index in these arteries and assess the relationship between resistive index and hemodynamically significant patent ductus arteriosus. MATERIALS AND METHODS Using Doppler imaging, we obtained resistive index values of internal carotid arteries, basilar artery, anterior cerebral artery, and pial and striatal arteries in the first 3 days of age and weekly thereafter until discharge or death. We analyzed paired observations using the Wilcoxon signed-rank test, between-group comparisons with the Mann-Whitney test. RESULTS We performed 771 examinations in 235 infants. Resistive indices differed among arteries: vessels with larger diameters showed significantly higher resistive indices. Resistive index in infants without patent ductus arteriosus was lower than that in infants with hemodynamically significant patent ductus arteriosus (median in anterior cerebral artery: 0.75 and 0.82, respectively; P<0.001), though this was not statistically significant in all arteries. There was no difference in pre- and post-ligation resistive indices in infants who underwent patent ductus arteriosus ligation. CONCLUSION For accurate follow-up and comparison of cerebral artery resistive index, the same artery should be examined on each occasion.
Collapse
Affiliation(s)
- Ginette M Ecury-Goossen
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| | - Marlou M A Raets
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| | - Fleur A Camfferman
- Department of Pediatrics, Division of Neonatology, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Rik H J Vos
- Department of Biomedical Engineering, Erasmus MC, Rotterdam, The Netherlands
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | | | - Irwin K M Reiss
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| | - Paul Govaert
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
- Department of Pediatrics, Koningin Paola Children's Hospital, Antwerp, Belgium
| | - Jeroen Dudink
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands.
- Department of Radiology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
| |
Collapse
|
10
|
Ecury-Goossen GM, van der Haer M, Smit LS, Feijen-Roon M, Lequin M, de Jonge RCJ, Govaert P, Dudink J. Neurodevelopmental outcome after neonatal perforator stroke. Dev Med Child Neurol 2016. [PMID: 26212612 DOI: 10.1111/dmcn.12857] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To assess outcome after neonatal perforator stroke in the largest cohort to date. METHOD Survivors from a cohort of children diagnosed with neonatal perforator stroke using cranial ultrasound or magnetic resonance imaging were eligible for inclusion. Recovery and Recurrence Questionnaire score, presence of cerebral palsy (CP), and crude outcome were assessed, specifically (1) the ability to walk independently, (2) participation in regular education, and (3) the presence of epilepsy. RESULTS Thirty-seven patients (20 males, 17 females) aged 3 to 14 years (mean age 8y) were included in the study: 14 with isolated single perforator stroke, four with multiple isolated perforator strokes, and 19 with additional brain injury. Out of 18 children with isolated perforator stroke(s), four had CP, one could not walk independently, and one developed epilepsy. The posterior limb of the internal capsule was involved in four out of 18 patients; three of these patients had CP. Of 19 children with additional brain injury, 11 had CP and three were not able to walk independently. Three out of nine children with concomitant cortical middle cerebral artery stroke developed epilepsy. INTERPRETATION Perforator stroke patterns can be of use in predicting long-term outcome and for guiding counselling and surveillance. Motor outcome was favourable in children with isolated perforator stroke(s), except when the posterior limb of the internal capsule was involved.
Collapse
Affiliation(s)
- Ginette M Ecury-Goossen
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Marit van der Haer
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Liesbeth S Smit
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.,Department of Neurology, Division of Pediatric Neurology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Monique Feijen-Roon
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Maarten Lequin
- Department of Radiology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Rogier C J de Jonge
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Paul Govaert
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.,Department of Pediatrics, Koningin Paola Children's Hospital, Antwerp, Belgium
| | - Jeroen Dudink
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.,Department of Radiology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| |
Collapse
|
11
|
Plaisier A, Raets MMA, Ecury-Goossen GM, Govaert P, Feijen-Roon M, Reiss IKM, Smit LS, Lequin MH, Dudink J. Serial cranial ultrasonography or early MRI for detecting preterm brain injury? Arch Dis Child Fetal Neonatal Ed 2015; 100:F293-300. [PMID: 25637006 DOI: 10.1136/archdischild-2014-306129] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 01/10/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate detection ability and feasibility of serial cranial ultrasonography (CUS) and early MRI in preterm brain injury. DESIGN Prospective cohort study. SETTING Level III neonatal intensive care unit. PATIENTS 307 infants, born below 29 weeks of gestation. METHODS Serial CUS and MRI were performed according to standard clinical protocol. In case of instability, MRI was postponed or cancelled. Brain images were assessed by independent experts and compared between modalities. MAIN OUTCOME MEASURES Presence of preterm brain injury on either CUS or MRI and discrepant imaging findings on CUS and MRI. RESULTS Serial CUS was performed in all infants; early MRI was often postponed (n=59) or cancelled (n=126). Injury was found in 146 infants (47.6%). Clinical characteristics differed significantly between groups that were subdivided according to timing of MRI. 61 discrepant imaging findings were found. MRI was superior in identifying cerebellar haemorrhage; CUS in detection of acute intraventricular haemorrhage, perforator stroke and cerebral sinovenous thrombosis. CONCLUSIONS Advanced serial CUS seems highly effective in diagnosing preterm brain injury, but may miss cerebellar abnormalities. Although MRI does identify these lesions, feasibility is limited. Improved safety, better availability and tailored procedures are essential for MRI to increase its value in clinical care.
Collapse
Affiliation(s)
- Annemarie Plaisier
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marlou M A Raets
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands
| | - Ginette M Ecury-Goossen
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands
| | - Paul Govaert
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands Department of Pediatrics, Koningin Paola Children's Hospital, Antwerp, Belgium
| | - Monique Feijen-Roon
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Irwin K M Reiss
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands
| | - Liesbeth S Smit
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands Division of Pediatric Neurology, Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Maarten H Lequin
- Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jeroen Dudink
- Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
12
|
Abstract
Cranial ultrasound (CUS) is a reputable tool for brain imaging in critically ill neonates. It is safe, relatively cheap and easy to use, even when a patient is unstable. In addition it is radiation-free and allows serial imaging. CUS possibilities have steadily expanded. However, in many neonatal intensive care units, these possibilities are not optimally used. We present a comprehensive approach for neonatal CUS, focusing on optimal settings, different probes, multiple acoustic windows and Doppler techniques. This approach is suited for both routine clinical practice and research purposes. In a live demonstration, we show how this technique is performed in the neonatal intensive care unit. Using optimal settings and probes allows for better imaging quality and improves the diagnostic value of CUS in experienced hands. Traditionally, images are obtained through the anterior fontanel. Use of supplemental acoustic windows (lambdoid, mastoid, and lateral fontanels) improves detection of brain injury. Adding Doppler studies allows screening of patency of large intracranial arteries and veins. Flow velocities and indices can be obtained. Doppler CUS offers the possibility of detecting cerebral sinovenous thrombosis at an early stage, creating a window for therapeutic intervention prior to thrombosis-induced tissue damage. Equipment, data storage and safety aspects are also addressed.
Collapse
Affiliation(s)
| | | | - Lara M Leijser
- Department of Pediatrics, Division of Neonatology, UZ Brussel; Department of Pediatrics, Division of Neonatology, Leiden University Medical Center
| | - Paul Govaert
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital; Department of Pediatrics, Division of Neonatology, Isala Hospital
| | - Jeroen Dudink
- Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital; Department of Radiology, Erasmus MC-Sophia Children's Hospital;
| |
Collapse
|
13
|
Camfferman FA, Ecury-Goossen GM, La Roche JE, de Jong N, van 't Leven W, Vos HJ, Verweij MD, Nasserinejad K, Cools F, Govaert P, Dudink J. Calibrating Doppler imaging of preterm intracerebral circulation using a microvessel flow phantom. Front Hum Neurosci 2015; 8:1068. [PMID: 25628560 PMCID: PMC4292584 DOI: 10.3389/fnhum.2014.01068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 12/22/2014] [Indexed: 12/02/2022] Open
Abstract
Introduction: Preterm infants are born during critical stages of brain development, in which the adaptive capacity of the fetus to extra-uterine environment is limited. Inadequate brain perfusion has been directly linked to preterm brain damage. Advanced high-frequency ultrasound probes and processing algorithms allow visualization of microvessels and depiction of regional variation. To assess whether visualization and flow velocity estimates of preterm cerebral perfusion using Doppler techniques are accurate, we conducted an in vitro experiment using a microvessel flow phantom. Materials and Methods: An in-house developed flow phantom containing two microvessels (inner diameter 200 and 700 μm) with attached syringe pumps, filled with blood-mimicking fluid, was used to generate non-pulsatile perfusion of variable flow. Measurements were performed using an Esaote MyLab70 scanner. Results: Microvessel mimicking catheters with velocities as low as 1 cm/s were adequately visualized with a linear ultrasound probe. With a convex probe, velocities <2 cm/s could not be depicted. Within settings, velocity and diameter measurements were highly reproducible [intra-class correlation 0.997 (95% CI 0.996–0.998) and 0.914 (0.864–0.946)]. Overall, mean velocity was overestimated up to threefold, especially in high velocity ranges. Significant differences were seen in velocity measurements when using steer angle correction and in vessel diameter estimation (p < 0.05). Conclusion: Visualization of microvessel-size catheters mimicking small brain vessels is feasible. Reproducible velocity and diameter results can be obtained, although important overestimation of the values is observed. Before velocity estimates of microcirculation can find its use in clinical practice, calibration of the ultrasound machine for any specific Doppler purpose is essential. The ultimate goal is to develop a sonographic tool that can be used for objective study of regional perfusion in routine practice.
Collapse
Affiliation(s)
- Fleur A Camfferman
- Department of Neonatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Brussels , Belgium
| | | | - Jhuresy E La Roche
- Department of Neonatology, Erasmus Medical Centre , Rotterdam , Netherlands
| | - Nico de Jong
- Department of Biomedical Engineering, Erasmus Medical Centre , Rotterdam , Netherlands ; Department of Imaging Physics, Delft University of Technology , Delft , Netherlands
| | - Willem van 't Leven
- Department of Biomedical Engineering, Erasmus Medical Centre , Rotterdam , Netherlands
| | - Hendrik J Vos
- Department of Biomedical Engineering, Erasmus Medical Centre , Rotterdam , Netherlands ; Department of Imaging Physics, Delft University of Technology , Delft , Netherlands
| | - Martin D Verweij
- Department of Imaging Physics, Delft University of Technology , Delft , Netherlands
| | - Kazem Nasserinejad
- Department of Biostatistics, Erasmus Medical Centre , Rotterdam , Netherlands
| | - Filip Cools
- Department of Neonatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Brussels , Belgium
| | - Paul Govaert
- Department of Neonatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Brussels , Belgium ; Department of Neonatology, Erasmus Medical Centre , Rotterdam , Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Erasmus Medical Centre , Rotterdam , Netherlands ; Department of Radiology, Erasmus Medical Centre , Rotterdam , Netherlands
| |
Collapse
|
14
|
Abstract
The objective of this study was to evaluate clinical symptoms and findings on cranial ultrasound (CUS) in preterm infants with cerebellar haemorrhage through retrospective analysis of all preterm infants with a postnatal CUS or MRI diagnosis of cerebellar haemorrhage admitted in a tertiary care centre between January 2002 and June 2009. Fifteen infants were identified; median gestational age was 25 2/7 weeks and median birth weight 730 g. We discerned six types of haemorrhage: subarachnoid (n = 3), folial (n = 1), lobar (n = 9, of which 4 bilateral), giant lobar (n = 1, including vermis) and contusional (n = 1). Especially in infants with lobar cerebellar haemorrhage, CUS showed preceding or concurrent lateral ventricle dilatation, mostly without intraventricular haemorrhage (IVH). Thirteen infants suffered from notable, otherwise unexplained motor agitation in the days preceding the diagnosis. In conclusion, motor agitation may be a presenting symptom of cerebellar haemorrhage in preterm infants. Unexplained ventriculomegaly can be a first sign of cerebellar haemorrhage and should instigate sonographic exploration of the cerebellum.
Collapse
Affiliation(s)
- Ginette M. Ecury-Goossen
- Department of Paediatrics, Division of Neonatology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands
- Sophia Children’s Hospital Erasmus MC, dr Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands
| | - Jeroen Dudink
- Department of Paediatrics, Division of Neonatology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands
- Department of Paediatrics, Division of Radiology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands
- Sophia Children’s Hospital Erasmus MC, dr Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands
| | - Maarten Lequin
- Department of Paediatrics, Division of Neonatology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands
- Department of Paediatrics, Division of Radiology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - Monique Feijen-Roon
- Department of Paediatrics, Division of Neonatology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - Sandra Horsch
- Department of Paediatrics, Division of Neonatology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - Paul Govaert
- Department of Paediatrics, Division of Neonatology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands
- Department of Paediatrics, Division of Radiology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands
| |
Collapse
|