scholarly journals Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis

2009 ◽  
Vol 29 (5) ◽  
pp. 343-351 ◽  
Author(s):  
J A Vanderveen ◽  
D Bassler ◽  
C M T Robertson ◽  
H Kirpalani
Keyword(s):  
Premature Infants ◽  
Meta Analysis ◽  
Early Interventions ◽  
Neurodevelopmental Outcomes

scholarly journals Maternal and Neonatal Polyunsaturated Fatty Acid Intake and Risk of Neurodevelopmental Impairment in Premature Infants

2022 ◽  
Vol 23 (2) ◽  
pp. 700
Author(s):  
Rory J. Heath ◽  
Susanna Klevebro ◽  
Thomas R. Wood
Keyword(s):  
Fatty Acids ◽  
Premature Infants ◽  
Placental Transfer ◽  
Meta Analysis ◽  
Narrative Review ◽  
Neurodevelopmental Outcomes ◽  
Infant Neurodevelopment ◽  
Pubmed Search ◽  
Study Designs ◽  
Prematurely Born Infants

The N3 and N6 long chain polyunsaturated fatty acids (LCPUFA) docosahexaenoic acid (DHA) and arachidonic acid (AA) are essential for proper neurodevelopment in early life. These fatty acids are passed from mother to infant via the placenta, accreting into fetal tissues such as brain and adipose tissue. Placental transfer of LCPUFA is highest in the final trimester, but this transfer is abruptly severed with premature birth. As such, efforts have been made to supplement the post-natal feed of premature infants with LCPUFA to improve neurodevelopmental outcomes. This narrative review analyzes the current body of evidence pertinent to neurodevelopmental outcomes after LCPUFA supplementation in prematurely born infants, which was identified via the reference lists of systematic and narrative reviews and PubMed search engine results. This review finds that, while the evidence is weakened by heterogeneity, it may be seen that feed comprising 0.3% DHA and 0.6% AA is associated with more positive neurodevelopmental outcomes than LCPUFA-deplete feed. While no new RCTs have been performed since the most recent Cochrane meta-analysis in 2016, this narrative review provides a wider commentary; the wider effects of LCPUFA supplementation in prematurely born infants, the physiology of LCPUFA accretion into preterm tissues, and the physiological effects of LCPUFA that affect neurodevelopment. We also discuss the roles of maternal LCPUFA status as a modifiable factor affecting the risk of preterm birth and infant neurodevelopmental outcomes. To better understand the role of LCPUFAs in infant neurodevelopment, future study designs must consider absolute and relative availabilities of all LCPUFA species and incorporate the LCPUFA status of both mother and infant in pre- and postnatal periods.

scholarly journals Erythropoietin monotherapy for neuroprotection after neonatal encephalopathy in low-to-middle income countries: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Phoebe Ivain ◽  
Paolo Montaldo ◽  
Aamir Khan ◽  
Ramyia Elagovan ◽  
Constance Burgod ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Neonatal Encephalopathy ◽  
Neurodevelopmental Outcomes ◽  
Term Infants ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pooled Data ◽  
Risk Of Death ◽  
Low Middle Income Countries ◽  
Near Term

Abstract Objective We examined whether erythropoietin monotherapy improves neurodevelopmental outcomes in near-term and term infants with neonatal encephalopathy (NE) in low-middle income countries (LMICs). Methods We searched Pubmed, Embase, and Web of Science databases to identify studies that used erythropoietin (1500–12,500 units/kg/dose) or a derivative to treat NE. Results Five studies, with a total of 348 infants in LMICs, were retrieved. However, only three of the five studies met the primary outcome of death or neuro-disability at 18 months of age or later. Erythropoietin reduced the risk of death (during the neonatal period and at follow-up) or neuro-disability at 18 months or later (p < 0.05). Death or neuro-disability occurred in 27.6% of the erythropoietin group and 49.7% of the comparison group (risk ratio 0.56 (95% CI: 0.42–0.75)). Conclusion The pooled data suggest that erythropoietin monotherapy may improve outcomes after NE in LMICs where therapeutic hypothermia is not available.

scholarly journals Bi-Level Noninvasive Ventilation in Neonatal Respiratory Distress Syndrome. A Systematic Review and Meta-Analysis

Neonatology ◽  
2021 ◽  
Vol 118 (3) ◽  
pp. 264-273
Author(s):  
Anne Lee Solevåg ◽  
Po-Yin Cheung ◽  
Georg M. Schmölzer
Keyword(s):  
Systematic Review ◽  
Continuous Positive Airway Pressure ◽  
Respiratory Distress Syndrome ◽  
Premature Infants ◽  
Airway Pressure ◽  
Distress Syndrome ◽  
Positive Airway Pressure ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled

<b><i>Background:</i></b> Bi-level noninvasive ventilation (NIV) has been used in respiratory distress syndrome (RDS) as primary treatment, post-extubation, and to treat apnea. This review summarizes studies on bi-level NIV in premature infants with RDS. Nonsynchronized nasal intermittent positive pressure ventilation (nsNIPPV) and synchronized NIPPV (SNIPPV) use pressure settings ≥ those used during mechanical ventilation (MV), and biphasic continuous positive airway pressure (BiPAP) use two nasal continuous positive airway pressure (NCPAP) levels ≤4 cm H<sub>2</sub>O apart. <b><i>Methods:</i></b> A systematic review (Medline OVID and Pubmed) and meta-analysis of randomized controlled trials. Primary outcomes were bronchopulmonary dysplasia (BPD) and mortality. Secondary outcomes included NIV failure (intubation) and extubation failure (re-intubation). Data were pooled using a fixed-effects model to calculate the relative risk (RR) with 95% confidence interval (CI) between NIV modes (RevMan v 5.3, Copenhagen, Denmark). <b><i>Results:</i></b> Twenty-four randomized controlled trials that largely did not correct for mean airway pressure (MAP) and used outdated ventilators were included. Compared with NCPAP, both nsNIPPV and SNIPPV resulted in less re-intubation (RR 0.88 with 95% CI (0.80, 0.97) and RR 0.20 (0.10, 0.38), respectively) and BPD (RR 0.69 (0.49, 0.97) and RR 0.51 (0.29, 0.88), respectively). nsNIPPV also resulted in less intubation (RR 0.57 (0.45, 0.73) versus NCPAP, with no difference in mortality. One study showed less intubation in BiPAP versus NCPAP. <b><i>Conclusions:</i></b> Bi-level NIV versus NCPAP may reduce MV and BPD in premature infants with RDS. Studies comparing equivalent MAP utilizing currently available machines are needed.

scholarly journals Early interventions to prevent psychosis: systematic review and meta-analysis

BMJ ◽  
2013 ◽  
Vol 346 (jan18 1) ◽  
pp. f185-f185 ◽  
Author(s):  
M. R. Stafford ◽  
H. Jackson ◽  
E. Mayo-Wilson ◽  
A. P. Morrison ◽  
T. Kendall
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Early Interventions

Preemptive interventions for infants and toddlers with a high likelihood for autism: A systematic review and meta-analysis

Autism ◽  
2021 ◽  
pp. 136236132110504
Author(s):  
Lauren H Hampton ◽  
Elizabeth M Rodriguez
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Child Outcomes ◽  
Developmental Outcomes ◽  
Autism Spectrum ◽  
Early Interventions ◽  
Infants And Toddlers ◽  
High Likelihood ◽  
Parent Implementation ◽  
The Impact

Understanding the impact of preemptive interventions on development for those with a high likelihood for autism is a critical step in building a transdiagnostic model of optimized intervention. The purpose of this systematic review and meta-analysis is to examine the impact of preemptive autism interventions on parent outcomes and child developmental outcomes. A total of 345 unique records were assessed for eligibility yielding 13 unique studies with 715 total infant/toddlers with a high likelihood for autism. There was a significant association between the early interventions on parent implementation of intervention strategies immediately following the intervention. However, there was no significant association between the early interventions and child developmental outcomes. The studies reporting moderator and/or mediator analyses suggest a meaningful association between parent implementation and long-term child social communication outcomes. Taken together, these findings suggest that parent-mediated interventions are associated with improved parent use of strategies, and although these results do not translate into immediate or short-term child developmental outcomes, there is evidence that parents with the greatest implementation facilitate later improved communication outcomes for their children. There is an urgent need to develop a nuanced intervention approach during a time of ever-changing concern about child development. Lay abstract Interventions to address core symptoms for young children on the autism spectrum have a strong and growing evidence base. Adapting and delivering evidence-based interventions to infants and toddlers with a high likelihood for autism is a logical next step. This systematic review and meta-analysis summarize the association between infant and toddler interventions and developmental and family outcomes. Results indicate that these early interventions are effective for improving parent implementation of core strategies, yet the effects do not readily translate to child outcomes. However, key studies demonstrate conditional results that indicate that parent implementation is associated with child outcome. Implications for research and practice toward building adaptive interventions that respond to parent implementation and changing child characteristics are discussed.

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