Neurological development and iron supplementation in healthy late-preterm neonates: a randomized double-blind controlled trial

AbstractLate-preterm infants (LPT) are at increased risk for long-term neurodevelopmental sequelae and iron deficiency. The aim of the study is to assess the positive effect of iron supplementation on psychomotor development in healthy LPT. We designed a randomized placebo-controlled double-blind trial dividing the newborns into two groups. Every patient was assessed using the Griffiths Mental Development Scales (GMDS)-II edition at 12-month post-conceptional age. The study was performed at the Neonatology Unit of our Hospital, in Italy. Sixty-six healthy LPT infants born between 340⁄7 and 366⁄7 weeks of gestational age were enrolled in the study. One group received martial prophylaxis from the third week of life to 6 months of post-conceptional age (2 mg/kg/day of iron pidolate), the other received placebo. Fifty-two of the enrolled infants were assessed using the GMDS at 12-month of post-conceptional age. Statistical analysis of the mean scores of the Griffiths subscales was performed. There was a difference in the mean developmental quotient (DQ) (p < 0.01) between the two groups: iron group mean DQ 121.45 ± 10.53 vs placebo group mean DQ 113.25 ± 9.70. Moreover, mean scores of the Griffiths subscales A, B, and D showed significant differences between the two groups (scale A p < 0.05, scale B p < 0.02, scale D p < 0.01, respectively).Conclusions: We recommend that all LPT neonates receive iron supplementation during the first 6 months of life in order to improve their 1-year neurodevelopmental quotient. What is Known:• Late-preterm infants (LPT) are at increased risk for long-term neurodevelopmental sequelae and also for iron deficiency.• Iron deficiency is an independent risk factor for adverse neurological outcomes. What is New:• Healthy late-preterm who received iron supplementation during the first 6 months of life achieved better neurological outcomes at 12-month post-conceptional age than LPT who received placebo.• Our study strongly supports the need for the implementation of martial prophylaxis in LPT neonates.

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Neurological Development and Iron Supplementation in Healthy Late-Preterm Neonates: A Randomized Double-Blind Controlled Trial

10.21203/rs.3.rs-268497/v1 ◽

2021 ◽

Author(s):

Rita Luciano ◽

Domenico Marco Romeo ◽

Giuseppina Mancini ◽

Serena Sivo ◽

Carolina Dolci ◽

...

Keyword(s):

Placebo Group ◽

Iron Supplementation ◽

Controlled Trial ◽

Preterm Neonates ◽

Neurological Development ◽

Double Blind ◽

Neurological Outcomes ◽

Increased Risk ◽

The Mean

Abstract ObjectiveLate-preterm infants (LPT) are at increased risk for long-term neurodevelopmental sequelaeand iron deficiency. Aim of the study is to assess the positive effect of iron supplementation on neurological development in healthy LPT.DesignWe designed a perspective, randomized placebo-controlled double-blind trial. The newborns were randomized in two groups: thirty-three patients received martial prophylaxis, thirty-three placebo. Every patient was assessed using the Griffith Mental Development Scales (GMDS)-II edition at 12 months of post-conceptional age.SettingThe study was performed at the Neonatology Unit of Fondazione Policlinico Gemelli IRCCS.PatientsSixty-six healthy LPT infants born between 340⁄7 and 366⁄7 weeks of Gestational Age were enrolled in the study.InterventionsOne group received martial prophylaxis from the third week of life to six months of post-conceptional age (2 mg/kg/day of iron pidolate), the other received placebo.Main outcome measuresFifty-two of the enrolled infants were assessed using the GMDS at 12-month of post-conceptional age. Statistical analysis of the mean scores of the Griffith subscales was performed.ResultsThere was a difference in the mean Developmental Quotient (DQ) (p<0.01) between the two groups: Iron Group mean DQ 121.45+10.53 vs Placebo Group mean DQ 113.25+9.70. Moreover, mean scores of the Griffith subscales A, B and D showed significant differences between the two Groups (scale A p<0.05, scale B p<0.02, scale D p<0.01 respectively).ConclusionsOur data show that newborns who received iron supplementation during the first six months of life achieved significantly better neurological outcomes at GMDS than Placebo group.

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Late Preterm Infants at Risk for Short-Term and Long Term Morbidity and Mortality

Neonatology ◽

10.1007/978-3-319-18159-2_159-1 ◽

2017 ◽

pp. 1-12

Author(s):

Avroy A. Fanaroff

Keyword(s):

At Risk ◽

Preterm Infants ◽

Late Preterm ◽

Morbidity And Mortality ◽

Short Term ◽

Late Preterm Infants

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Long-term cognitive, executive, and behavioral outcomes of moderate and late preterm at school age

Clinical and Experimental Pediatrics ◽

10.3345/kjp.2019.00647 ◽

2020 ◽

Vol 63 (6) ◽

pp. 219-225 ◽

Cited By ~ 2

Author(s):

Ju Hyun Jin ◽

Shin Won Yoon ◽

Jungeun Song ◽

Seong Woo Kim ◽

Hee Jung Chung

Keyword(s):

Executive Function ◽

Preterm Infants ◽

Behavioral Problems ◽

Chromosomal Abnormalities ◽

Attention Problems ◽

Late Preterm ◽

School Age ◽

Late Preterm Infants ◽

The Mean ◽

Borderline Intelligence

Background: There is increasing concern that moderate preterm (32–33 weeks’ gestation) and late preterm (34–36 weeks’ gestation) birth may be associated with minor neurodevelopmental problems affecting poor school performance.Purpose: We explored the cognitive function, cognitive visual function, executive function, and behavioral problems at schoolage in moderate to late preterm infants.Methods: Children aged 7–10 years who were born at 32+0 to 36+6 weeks of gestation and admitted to the neonatal intensive care unit from August 2006 to July 2011 at the National Health Insurance Service Ilsan Hospital were included. We excluded children with severe neurologic impairments, congenital malformations, or chromosomal abnormalities. Neuropsychological assessments consisted of 5 neuropsychological tests and 3 questionnaires.Results: A total of 37 children (mean age, 9.1±1.2 years) participated. The mean gestational age at birth was 34.6±7.5 weeks, while the mean birth weight was 2,229.2±472.8 g. The mean full-scale intelligence quotient was 92.89±11.90; 24.3% scored between 70 and 85 (borderline intelligence functioning). An abnormal score was noted for at least one of the variables on the attention deficit hyperactivity disorder diagnostic system for 65% of the children. Scores below borderline function for executive quotient and memory quotient were 32.4% and 24.3%, respectively. Borderline or clinically relevant internalizing problems were noted in 13.5% on the Child Behavior Check List. There were no significant associations between perinatal factors or socioeconomic status and cognitive, visual perception, executive function, or behavior outcomes.Conclusion: Moderate to late preterm infants are at risk of developing borderline intelligence functioning and attention problems at early school age. Cognitive and executive functions that are important for academic performance must be carefully monitored and continuously followed up in moderate to late preterm infants.

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Breastfeeding Self-Efficacy and Its Relationship with the Perceived Stress and the Breastfeeding Performance in Iranian Mothers with Late Preterm Infants, 2019

10.21203/rs.3.rs-87806/v1 ◽

2020 ◽

Author(s):

Akram Kahforoushan ◽

Shirin Hasanpour ◽

Mojgan Mirghafourvand

Keyword(s):

Standard Deviation ◽

Linear Regression ◽

Multiple Linear Regression ◽

Preterm Infants ◽

Perceived Stress ◽

Self Efficacy ◽

Short Form ◽

Late Preterm ◽

Late Preterm Infants ◽

The Mean

Abstract BackgroundLate preterm infants suffer from many short-term and long-term problems after birth. The key factor in fighting these problems is effective breastfeeding. The present study aimedto determine the breastfeeding self-efficacy and its relationship with the perceived stress and breastfeeding performance in mothers with late preterm infants. MethodsIn this prospective study, 171 nursing mothers with late preterm infants born in Alzahra Medical Center of Tabriz, Iran, who met the conditions of this study were selected through convenience sampling. The Breastfeeding Self-Efficacy Scale-Short Form (BSES- SF) was employed to measure breastfeeding self-efficacy and 14-item Perceived Stress Scale (PSS14) was used to measure the perceived stress during 24 hours after giving birth and when the child was 4 months old the breastfeeding performance was measured by the standard breastfeeding performance questionnaire. The data were analyzed by Pearson and Spearman’s correlation tests, independent t-test, one-way ANOVA, and Multiple Linear Regression.ResultsThe mean (standard deviation) of breastfeeding self-efficacy equaled 50.0 (7.8) from the scores ranging between13-65 and the mean (standard deviation) of the perceived stress equaled to 26.5 (8.8) from the scores ranging between 0-56. The median (25-75 percentiles) of breastfeeding performance score in the mothers equaled 2.0 (1.0 to 3.0) from the scores ranging between 0-6. On the basis of multiple linear regression and through adjusting the personal-social characteristic, by increasing the score of the breastfeeding self-efficacy, the perceived stress was decreased to a statistically significant amount (B=-0.1, 95%CI=-0.3 to 0.0), however, there was no statistically significant relationship between breastfeeding self-efficacy and breastfeeding performance (p=0.418). ConclusionDue to the modifiable variability of breastfeeding self-efficacy and its role in perceived maternal stress, the development of appropriate strategies to further increase breastfeeding self-efficacy and provide more support to these mothers and infants is of particular importance.

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Increased Risk of Adverse Neurological Development for Late Preterm Infants

MCN The American Journal of Maternal/Child Nursing ◽

10.1097/01.nmc.0000351712.11997.8c ◽

2009 ◽

Vol 34 (3) ◽

pp. 196

Author(s):

Linda Beth Tiedje

Keyword(s):

Preterm Infants ◽

Late Preterm ◽

Neurological Development ◽

Late Preterm Infants ◽

Increased Risk

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Increased Risk of Adverse Neurological Development for Late Preterm Infants

Yearbook of Pediatrics ◽

10.1016/s0084-3954(09)79346-7 ◽

2010 ◽

Vol 2010 ◽

pp. 411-412

Author(s):

J.A. Stockman

Keyword(s):

Preterm Infants ◽

Late Preterm ◽

Neurological Development ◽

Late Preterm Infants ◽

Increased Risk

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Long-term Cognition, Achievement, Socioemotional, and Behavioral Development of Healthy Late-Preterm Infants

Archives of Pediatrics and Adolescent Medicine ◽

10.1001/archpediatrics.2010.83 ◽

2010 ◽

Vol 164 (6) ◽

Cited By ~ 75

Author(s):

Matthew J. Gurka ◽

Jennifer LoCasale-Crouch ◽

James A. Blackman

Keyword(s):

Preterm Infants ◽

Behavioral Development ◽

Late Preterm ◽

Late Preterm Infants

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Early skin-to-skin contact between healthy late preterm infants and their parents: an observational cohort study

PeerJ ◽

10.7717/peerj.3949 ◽

2017 ◽

Vol 5 ◽

pp. e3949 ◽

Cited By ~ 3

Author(s):

Kerstin H. Nyqvist ◽

Andreas Rosenblad ◽

Helena Volgsten ◽

Eva-Lotta Funkquist ◽

Elisabet Mattsson

Keyword(s):

Cohort Study ◽

Preterm Infants ◽

Linear Regression Analysis ◽

Observational Cohort Study ◽

Late Preterm ◽

Late Preterm Infants ◽

Skin Contact ◽

Observational Cohort ◽

The Mean ◽

Skin To Skin

Background Skin-to-skin contact (SSC) is an important factor to consider in the care of late preterm infants (born between 34 0/7 and 36 6/7 completed weeks of gestation). The literature suggests that SSC between preterm infants and their mothers facilitates breastfeeding. However, more studies are needed to explore potential dose-response effects between SSC and breastfeeding as well as studies that explicitly investigate SSC by fathers among late preterm infants. The aim was to investigate the duration of healthy late preterm infants’ SSC with the mother and father, respectively, during the first 48 h after birth and the associations with breastfeeding (exclusive/partial at discharged), clinical and demographic variables. Methods This was an observational cohort study in which parents to healthy late preterm infants, born between 34 5/7 and 36 6/7 completed weeks of gestation, recorded duration of SSC provided by mother and father, respectively. Demographic and clinical variables were retrieved from the medical records and were used as predictors. Multiple linear regression analysis was used to assess the association between the predictors and the outcome, SSC (hours), separately for mothers and fathers. Results The mean (standard deviation [SD]) time per day spent with SSC with mothers (n = 64) and fathers (n = 64), was 14.7 (5.6) and 4.4 (3.3) hours during the first day (24 h) after birth and 9.2 (7.1) and 3.1 (3.3) hours during the second day (24 h), respectively. Regarding SSC with mothers, no variable was significantly associated with SSC during the first day, while the mean (95% confidence interval [CI]) time of SSC during the second day was 6.9 (1.4–12.4) hours shorter for each additional kg of birthweight (p = 0.014). Concerning SSC with fathers, the mean (95% CI) time of SSC during the first day was 2.1 (0.4–3.7) hours longer for infants born at night (p = 0.015), 1.7 (0.1–3.2) hours longer for boys (p = 0.033), 3.2 (1.2–5.2) hours longer for infants born by caesarean section (p = 0.003), and 1.6 (0.1–3.1) hours longer for infants exclusively breastfed at discharge (p = 0.040). During the second day, the mean (95% CI) time of SSC with fathers was 3.0 (0.6–5.4) hours shorter for each additional kg of birthweight (p = 0.014), 2.0 (0.5–3.6) hours longer for infants born during night-time (p = 0.011), 2.9 (1.4–4.4) hours longer if the mother was primipara (p < 0.001), and 1.9 (0.3–3.5) hours shorter if supplementary artificial milk feeds were given. None of the other predictors, i.e., mother’s age, gestational age, or induction of labor were significantly associated with infants’ SSC with mothers or fathers during any of the first two days after birth. Conclusion Future studies are warranted that investigate duration of SSC between late preterm infants and their parents separately and the associations with breastfeeding and other variables of clinical importance.

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