Neonatal Cranial Ultrasound Findings Among Infants Born Extremely Preterm: Associations With Neurodevelopmental Outcomes at Ten Years of Age

2021 ◽  
Author(s):  
Heather Campbell ◽  
Jennifer Check ◽  
Karl C.K. Kuban ◽  
Alan Leviton ◽  
Robert M. Joseph ◽  
...  
Keyword(s):  
Cranial Ultrasound ◽  
Neurodevelopmental Outcomes ◽  
Extremely Preterm ◽  
Ultrasound Findings

scholarly journals School-age outcomes following intraventricular haemorrhage in infants born extremely preterm

2020 ◽  
Vol 106 (1) ◽  
pp. 4-8 ◽  
Author(s):  
Nicky Laura Hollebrandse ◽  
Alicia J Spittle ◽  
Alice C Burnett ◽  
Peter J Anderson ◽  
Gehan Roberts ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Executive Function ◽  
Motor Function ◽  
Intraventricular Haemorrhage ◽  
Academic Skills ◽  
Intellectual Ability ◽  
Low Grade ◽  
Cranial Ultrasound ◽  
Neurodevelopmental Outcomes ◽  
Extremely Preterm

ObjectiveTo determine the associations of different grades of intraventricular haemorrhage (IVH), particularly grades 1 and 2, with neurodevelopmental outcomes at 8 years of age in children born extremely preterm.DesignPopulation-based cohort study.SettingState of Victoria, Australia.PatientsSurvivors born at <28 weeks’ gestational age (n=546) and matched term-born controls (n=679) from three distinct eras, namely, those born in 1991–1992, 1997 and 2005.ExposureWorst grade of IVH detected on serial neonatal cranial ultrasound.Outcome measuresIntellectual ability, executive function, academic skills, cerebral palsy and motor function at 8 years.ResultsThere was a trend for increased motor dysfunction with increasing severity of all grades of IVH, from 24% with no IVH, rising to 92% with grade 4 IVH. Children with grade 1 or 2 IVH were at higher risk of developing cerebral palsy than those without IVH (OR 2.24, 95% CI 1.21 to 4.16). Increased rates of impairment in intellectual ability and academic skills were observed with higher grades of IVH, but not for grade 1 and 2 IVH. Parent-rated executive functioning was not related to IVH.ConclusionWhile low-grade IVH is generally considered benign, it was associated with higher rates of cerebral palsy in school-aged children born EP, but not with intellectual ability, executive function, academic skills or overall motor function. Higher grades of IVH were associated with higher rates and risks of impairment in motor function, intellectual ability and some academic skills, but not parental ratings of executive function.

scholarly journals Early oxygen levels contribute to brain injury in extremely preterm infants

2021 ◽  
Author(s):  
Krista Rantakari ◽  
Olli-Pekka Rinta-Koski ◽  
Marjo Metsäranta ◽  
Jaakko Hollmén ◽  
Simo Särkkä ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Brain Structures ◽  
High Oxygen ◽  
List Type ◽  
Neurodevelopmental Outcomes ◽  
Oxygen Levels ◽  
Arterial Blood ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Abstract Background Extremely low gestational age newborns (ELGANs) are at risk of neurodevelopmental impairments that may originate in early NICU care. We hypothesized that early oxygen saturations (SpO2), arterial pO2 levels, and supplemental oxygen (FiO2) would associate with later neuroanatomic changes. Methods SpO2, arterial blood gases, and FiO2 from 73 ELGANs (GA 26.4 ± 1.2; BW 867 ± 179 g) during the first 3 postnatal days were correlated with later white matter injury (WM, MRI, n = 69), secondary cortical somatosensory processing in magnetoencephalography (MEG-SII, n = 39), Hempel neurological examination (n = 66), and developmental quotients of Griffiths Mental Developmental Scales (GMDS, n = 58). Results The ELGANs with later WM abnormalities exhibited lower SpO2 and pO2 levels, and higher FiO2 need during the first 3 days than those with normal WM. They also had higher pCO2 values. The infants with abnormal MEG-SII showed opposite findings, i.e., displayed higher SpO2 and pO2 levels and lower FiO2 need, than those with better outcomes. Severe WM changes and abnormal MEG-SII were correlated with adverse neurodevelopment. Conclusions Low oxygen levels and high FiO2 need during the NICU care associate with WM abnormalities, whereas higher oxygen levels correlate with abnormal MEG-SII. The results may indicate certain brain structures being more vulnerable to hypoxia and others to hyperoxia, thus emphasizing the role of strict saturation targets. Impact This study indicates that both abnormally low and high oxygen levels during early NICU care are harmful for later neurodevelopmental outcomes in preterm neonates. Specific brain structures seem to be vulnerable to low and others to high oxygen levels. The findings may have clinical implications as oxygen is one of the most common therapies given in NICUs. The results emphasize the role of strict saturation targets during the early postnatal period in preterm infants.

scholarly journals Neonatal hyperglycaemia is associated with worse neurodevelopmental outcomes in extremely preterm infants

2021 ◽  
pp. fetalneonatal-2020-319926
Author(s):  
Itay Zamir ◽  
Elisabeth Stoltz Sjöström ◽  
Fredrik Ahlsson ◽  
Ingrid Hansen-Pupp ◽  
Fredrik Serenius ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Outcome Measures ◽  
Insulin Treatment ◽  
Neurodevelopmental Outcomes ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
National Cohort ◽  
Lower Intelligence ◽  
Randomised Controlled ◽  
Neonatal Hyperglycaemia

ObjectiveTo assess the associations between neonatal hyperglycaemia and insulin treatment, versus long-term neurodevelopmental outcomes in children born extremely preterm.Design and settingObservational national cohort study (Extremely Preterm Infants in Sweden Study) using prospectively and retrospectively collected data. Neurodevelopmental assessment was performed at 6.5 years of age.Patients533 infants born <27 gestational weeks during 2004–2007; 436 survivors were assessed at 6.5 years.Outcome measuresNeurodevelopmental disability (NDD), survival without moderate to severe NDD, Wechsler Intelligence Scale for Children IV Full scale intelligence quotient (WISC-IV FSIQ) and Movement Assessment Battery for Children 2 (MABC-2) total score.ResultsDuration of neonatal hyperglycaemia >8 mmol/L was associated with WISC-IV scores—for each day with hyperglycaemia there was a decrease of 0.33 points (95% CI 0.03 to 0.62) in FSIQ. Neonatal hyperglycaemia >8 mmol/L occurring on 3 consecutive days was associated with lower MABC-2 scores (adjusted mean difference: −4.90; 95% CI −8.90 to −0.89). For each day with hyperglycaemia >8 mmol/L, there was a decrease of 0.55 points (95% CI 0.17 to 0.93) in MABC-2 total score. Insulin treatment was not associated with any of the outcome measures.ConclusionNeonatal hyperglycaemia >8 mmol/L was associated with lower intelligence scores and worse motor outcomes at 6.5 years of age. Insulin treatment was not associated with either worsened or improved neurodevelopmental outcomes. Randomised controlled trials are needed to clarify the role of insulin in treating hyperglycaemia in extremely preterm infants.

scholarly journals Association of Antenatal Corticosteroids With Mortality, Morbidity, and Neurodevelopmental Outcomes in Extremely Preterm Multiple Gestation Infants

2016 ◽  
Vol 170 (6) ◽  
pp. 593 ◽  
Author(s):  
Nansi S. Boghossian ◽  
Scott A. McDonald ◽  
Edward F. Bell ◽  
Waldemar A. Carlo ◽  
Jane E. Brumbaugh ◽  
...  
Keyword(s):  
Multiple Gestation ◽  
Antenatal Corticosteroids ◽  
Neurodevelopmental Outcomes ◽  
Extremely Preterm

Extremely preterm infant with persistent peeling skin: X-linked ichthyosis imitates prematurity

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Brigitte Burcescu ◽  
Heather L. Brumberg ◽  
Shetal I. Shah
Keyword(s):  
Preterm Infant ◽  
Genetic Disorder ◽  
Steroid Sulfatase ◽  
Neurodevelopmental Outcomes ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Surfactant Production ◽  
Age Of Diagnosis ◽  
Scaly Skin

Abstract Objectives X-linked ichthyosis (XLI) is a genetic disorder caused by a deficiency in steroid sulfatase, an enzyme which catalyzes a reaction in estrone synthesis. The disorder primarily manifests as dry, scaly skin which may be difficult to diagnose in extremely preterm infants, as the dermatological features may be falsely attributed to a normal variant of skin for this population. Case presentation In this case report, we describe a male with XLI, born at 24 weeks gestation, who had persistent dry, flaky and hyperpigmented skin. This case is notable for the age of diagnosis in an extremely premature infant; day of life 105. In addition, this infant experienced out of proportion bronchopulmonary symptoms that we postulate may be linked to the steroid sulfatase deficiency, as estrogen is a mediator of surfactant production. Conclusions This report underscores the need to potentially evaluate persistent dry, flaky skin in the preterm infant, as XLI may also impact long term neurodevelopmental outcomes.

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