scholarly journals Retinopathy of Prematurity and Bronchopulmonary Dysplasia are Independent Antecedents of Cortical Maturational Abnormalities in Very Preterm Infants

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Julia E. Kline ◽  
Venkata Sita Priyanka Illapani ◽  
Lili He ◽  
Mekibib Altaye ◽  
Nehal A. Parikh
Keyword(s):  
Surface Area ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Brain Mri ◽  
Full Term ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Equivalent Age ◽  
Very Preterm

AbstractVery preterm (VPT) infants are at high-risk for neurodevelopmental impairments, however there are few validated biomarkers at term-equivalent age that accurately measure abnormal brain development and predict future impairments. Our objectives were to quantify and contrast cortical features between full-term and VPT infants at term and to associate two key antecedent risk factors, bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP), with cortical maturational changes in VPT infants. We prospectively enrolled a population-based cohort of 110 VPT infants (gestational age ≤31 weeks) and 51 healthy full-term infants (gestational age 38–42 weeks). Structural brain MRI was performed at term. 94 VPT infants and 46 full-term infants with high-quality T2-weighted MRI were analyzed. As compared to full-term infants, VPT infants exhibited significant global cortical maturational abnormalities, including reduced surface area (−5.9%) and gyrification (−6.7%) and increased curvature (5.9%). In multivariable regression controlled for important covariates, BPD was significantly negatively correlated with lobar and global cortical surface area and ROP was significantly negatively correlated with lobar and global sulcal depth in VPT infants. Our cohort of VPT infants exhibited widespread cortical maturation abnormalities by term-equivalent age that were in part anteceded by two of the most potent neonatal diseases, BPD and ROP.

Very preterm infants displayed similar imitation skills to full‐term infants at term equivalent age

2021 ◽  
Author(s):  
Claire Koenig‐Zores ◽  
Mathilde Davy‐Monteil ◽  
Véronique Vincent ◽  
Dominique Astruc ◽  
Nicolas Meyer ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Full Term ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Equivalent Age ◽  
Very Preterm

scholarly journals Hospitalizations for respiratory syncytial virus bronchiolitis in preterm infants at <33 weeks gestation without bronchopulmonary dysplasia: the CASTOR study

2012 ◽  
Vol 141 (4) ◽  
pp. 816-826 ◽  
Author(s):  
J.-B. GOUYON ◽  
J.-C. ROZÉ ◽  
C. GUILLERMET-FROMENTIN ◽  
I. GLORIEUX ◽  
L. ADAMON ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Full Term ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Hospitalization Rates ◽  
Syncytial Virus ◽  
Country Specific

SUMMARYThis study was conducted during the 2008–2009 respiratory syncytial virus (RSV) season in France to compare hospitalization rates for bronchiolitis (RSV-confirmed and all types) between very preterm infants (<33 weeks' gestational age, WGA) without bronchopulmonary dysplasia and full-term infants (39–41 WGA) matched for date of birth, gender and birth location, and to evaluate the country-specific risk factors for bronchiolitis hospitalization. Data on hospitalizations were collected both retrospectively and prospectively for 498 matched infants (249 per group) aged <6 months at the beginning of the RSV season. Compared to full-term infants, preterm infants had a fourfold [95% confidence interval (CI) 1·36–11·80] and a sevenfold (95% CI 2·79–17·57) higher risk of being hospitalized for bronchiolitis, RSV-confirmed and all types, respectively. Prematurity was the only factor that significantly increased the risk of being hospitalized for bronchiolitis. The risk of multiple hospitalizations for bronchiolitis in the same infant significantly increased with male gender and the presence of siblings aged ⩾2 years.

scholarly journals Novel Diffuse White Matter Abnormality Biomarker at Term-Equivalent Age Enhances Prediction of Long-term Motor Development in Children Born Very Preterm

2020 ◽  
Author(s):  
Nehal A Parikh ◽  
Karen Harpster ◽  
Lili He ◽  
Venkata Sita Priyanka Illapani ◽  
Fatima Chughtai Khalid ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Motor Development ◽  
Prognostic Biomarker ◽  
White Matter Abnormality ◽  
Very Preterm Infants ◽  
Equivalent Age ◽  
Very Preterm ◽  
Diffuse White Matter

Our objective was to evaluate the independent prognostic value of a novel MRI biomarker − objectively diagnosed diffuse white matter abnormality volume (DWMA; diffuse excessive high signal intensity) − for prediction of motor outcomes in very preterm infants. We prospectively enrolled a geographically-based cohort of very preterm infants without severe brain injury and born before 32 weeks gestational age. Structural brain MRI was obtained at term-equivalent age and DWMA volume was objectively quantified using a published validated algorithm. These results were compared with visually classified DWMA. We used multivariable linear regression to assess the value of DWMA volume, independent of known predictors, to predict motor development as assessed using the Bayley Scales of Infant & Toddler Development, Third Edition at 3 years of age. The mean (SD) gestational age of the cohort was 28.3 (2.4) weeks. In multivariable analyses, controlling for gestational age, sex, and abnormality on structural MRI, DWMA volume was an independent prognostic biomarker of Bayley Motor scores (β= −12.59 [95% CI: −18.70, −6.48] R2=0.41). Conversely, visually classified DWMA was not predictive of motor development. In conclusion, objectively quantified DWMA is an independent prognostic biomarker of long-term motor development in very preterm infants and warrants further study.

scholarly journals Stereophotogrammetric head shape assessment in neonates is feasible and can identify distinct differences between term-born and very preterm infants at term equivalent age

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Petra Santander ◽  
Anja Quast ◽  
Johanna Hubbert ◽  
Laura Juenemann ◽  
Sebastian Horn ◽  
...  
Keyword(s):  
Body Weight ◽  
Preterm Infants ◽  
Total Duration ◽  
Neurodevelopmental Outcome ◽  
Small Sample ◽  
Head Shape ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Equivalent Age ◽  
Very Preterm

AbstractThe development of head shape and volume may reflect neurodevelopmental outcome and therefore is of paramount importance in neonatal care. Here, we compare head morphology in 25 very preterm infants with a birth weight of below 1500 g and / or a gestational age (GA) before 32 completed weeks to 25 term infants with a GA of 37–42 weeks at term equivalent age (TEA) and identify possible risk factors for non-synostotic head shape deformities. For three-dimensional head assessments, a portable stereophotogrammetric device was used. The most common and distinct head shape deformity in preterm infants was dolichocephaly. Severity of dolichocephaly correlated with GA and body weight at TEA but not with other factors such as neonatal morbidity, sex or total duration of respiratory support. Head circumference (HC) and cranial volume (CV) were not significantly different between the preterm and term infant group. Digitally measured HC and the CV significantly correlated even in infants with head shape deformities. Our study shows that stereophotogrammetric head assessment is feasible in all preterm and term infants and provides valuable information on volumetry and comprehensive head shape characteristics. In a small sample of preterm infants, body weight at TEA was identified as a specific risk factor for the development of dolichocephaly.

scholarly journals Perinatal Risk and Protective Factors in the Development of Diffuse White Matter Abnormality on Term-Equivalent Age MRI in Infants Born Very Preterm

2020 ◽  
Author(s):  
Nehal A Parikh ◽  
Puneet Sharma ◽  
Lili He ◽  
Hailong Li ◽  
Mekibib Altaye ◽  
...  
Keyword(s):  
White Matter ◽  
Protective Factors ◽  
Preterm Infants ◽  
Brain Mri ◽  
White Matter Abnormality ◽  
Maternal Milk ◽  
Very Preterm Infants ◽  
Equivalent Age ◽  
Very Preterm ◽  
Diffuse White Matter

Importance: Diffuse white matter abnormality (DWMA) is the most common brain MRI finding in very preterm infants and is predictive of neurodevelopmental impairments. However, its etiology remains elusive and identifying perinatal risk and protective factors may allow clinicians to reduce the burden of DWMA. Objective: To identify perinatal clinical factors that are associated with the development of objectively diagnosed DWMA in very preterm infants. Design: A prospective cohort was enrolled between September 2016 and November 2019. Brain MRIs were collected at 39 to 45 weeks postmenstrual age (PMA) to evaluate DWMA volume. A pre-defined list of pertinent maternal characteristics, pregnancy/delivery data, and neonatal ICU data was collected for enrolled patients to identify antecedents of objectively diagnosed DWMA. Setting: Five level III/IV NICUs in the greater Cincinnati, Ohio area. Participants: A population-based sample of 392 very preterm infants born before 33 weeks gestational age. Exposure: Very preterm birth with associated diseases and treatments. Main Outcome and Measure: Objectively diagnosed DWMA volume on brain MRI at term-equivalent age. Results: 377 of the 392 very preterm infants (96%) had high quality MRI data. Mean (SD) gestational age was 29.3 (2.5) weeks. In multivariable linear regression analyses, pneumothorax (p=.027), severe bronchopulmonary dysplasia (BPD) (p=.009), severe retinopathy of prematurity (ROP) (p<0.001), and male sex (p=.041) were associated with increasing volume of DWMA. The following factors were associated with decreased risk of DWMA: dexamethasone for severe BPD (p=.004), duration of caffeine for severe BPD (p = 0.009), and exclusive maternal milk at NICU discharge (p=.049). Conclusions and Relevance: Severe ROP and BPD exhibited the strongest adverse association with the development of DWMA. Caffeine and dexamethasone treatments for infants with severe BPD exhibited a protective effect against development of DWMA. The beneficial association with maternal milk is also a modifiable factor that has clinical implications.

scholarly journals Relation of Retinopathy of Prematurity to Brain Volumes at Term Equivalent Age and Developmental Outcome at 2 Years of Corrected Age in Very Preterm Infants

Neonatology ◽  
2018 ◽  
Vol 114 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Kristbjörg Sveinsdóttir ◽  
David Ley ◽  
Holger Hövel ◽  
Vineta Fellman ◽  
Petra S. Hüppi ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Retinopathy Of Prematurity ◽  
Developmental Outcome ◽  
Brain Volumes ◽  
Very Preterm Infants ◽  
Equivalent Age ◽  
Very Preterm

scholarly journals Author Correction: Retinopathy of Prematurity and Bronchopulmonary Dysplasia are Independent Antecedents of Cortical Maturational Abnormalities in Very Preterm Infants

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julia E. Kline ◽  
Venkata Sita Priyanka Illapani ◽  
Lili He ◽  
Mekibib Altaye ◽  
Nehal A. Parikh
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Retinopathy Of Prematurity ◽  
Very Preterm Infants ◽  
Very Preterm

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Screening for Retinopathy of Prematurity in Very Preterm Children: The EPIPAGE-2 Cohort Study

Neonatology ◽  
2021 ◽  
Vol 118 (1) ◽  
pp. 80-89
Author(s):  
Thibaut Chapron ◽  
Georges Caputo ◽  
Vèronique Pierrat ◽  
Elsa Kermorvant ◽  
Amandine Barjol ◽  
...  
Keyword(s):  
Cohort Study ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Wide Angle ◽  
Related Factors ◽  
Factors Associated ◽  
Very Preterm ◽  
Local Protocol ◽  
Rop Screening

<b><i>Introduction:</i></b> Retinopathy of prematurity (ROP) is a blinding disease that requires screening by retinal examination. Screening practices are rarely evaluated. We aimed to determine the prevalence of ROP screening in very preterm infants and individual- and center-related factors associated with ROP screening. <b><i>Methods:</i></b> Data were extracted from the EPIPAGE-2 cohort, a French prospective population-based study of premature births in 2011. Children born before 32 weeks’ gestation (WG) without severe malformation and alive at the recommended time for ROP screening were included. Outcome measures were achievement of ROP screening and compliance with recommended screening timeline. Individual- and center-related factors associated with both measures were studied using mixed models. <b><i>Results:</i></b> Among 3,077 eligible infants, 2,169 (70.5%) had a ROP screening, ranging from 96% at 24 WG to 50% at 31 WG. Large variability among units was observed. Individual characteristics associated with screening were low gestational age, low birth weight, severe bronchopulmonary dysplasia or neurological lesions, and transfer between neonatal units during the screening period. Odds of screening were higher in neonatal units using wide-angle imaging (odds ratio 2.65 [95% confidence interval 1.17–6.01]) but decreased in units without a local protocol for ROP screening (0.03 [0.01–0.09]). Among screened children, 1,641/2,169 (75.7%) were screened according to recommended timeline. Delayed screening was associated with low gestational age, severe bronchopulmonary dysplasia or necrotizing enterocolitis, and absence of local protocol for ROP screening. <b><i>Discussion/Conclusions:</i></b> In this large cohort study of infants born very preterm, almost one-third were not screened for ROP. Children most at risk for ROP were the best screened but often with delay. The higher compliance of neonatal units using wide-angle imaging systems supports its use.

scholarly journals Asymptomatic late thrombocytosis is a common finding in very preterm infants even in the absence of erythropoietin treatment

2019 ◽  
Vol 47 (4) ◽  
pp. 1504-1511 ◽  
Author(s):  
Beatriz Del Rey Hurtado de Mendoza ◽  
Carla Balcells Esponera ◽  
Montserrat Izquierdo Renau ◽  
Isabel Iglesias Platas
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Hematological Parameters ◽  
Common Finding ◽  
Recombinant Erythropoietin ◽  
Vascular Events ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Erythropoietin Treatment

Objectives Thrombocytosis is more prevalent in pediatric than in adult patients and is associated with complications or worsened outcomes after vascular events. This study aimed to determine the prevalence of thrombocytosis in very preterm infants who had not received human recombinant erythropoietin treatment (rHuEPO) and its relationship with other hematological parameters and clinical complications. Methods We performed a retrospective study of hematological and clinical data of very preterm infants who were admitted to our unit in their first 48 hours of life and stayed for longer than 1 week. Results Thrombocytosis was prevalent (32.6% of patients) in very preterm infants (≤32 weeks of gestational age, n = 193) who had not received rHuEPO. The platelet count was positively correlated with calendar age. Infants with thrombocytosis were significantly more premature (28.0 ± 2.1 versus 29.6 ± 2.2 weeks) and had a lower birth weight (1036 ± 304 versus 1303 ± 304) than those without thrombocytosis. Thrombocytosis was associated with retinopathy of prematurity after adjusting for gestational age and comorbidities, but not with other prematurity-associated complications. Conclusions Late asymptomatic thrombocytosis is common in very preterm infants at approximately 1 month of postnatal age and it may be associated with retinopathy of prematurity.

scholarly journals Early cortical maturation predicts neurodevelopment in very preterm infants

2019 ◽  
Vol 105 (5) ◽  
pp. 460-465 ◽  
Author(s):  
Julia E Kline ◽  
Venkata Sita Priyanka Illapani ◽  
Lili He ◽  
Mekibib Altaye ◽  
John Wells Logan ◽  
...  
Keyword(s):  
Language Development ◽  
Surface Area ◽  
Neonatal Intensive Care ◽  
Brain Mri ◽  
Cortical Surface ◽  
Very Preterm Infants ◽  
Cortical Surface Area ◽  
Very Preterm ◽  
Human Connectome Project ◽  
Cortical Maturation

ObjectiveTo evaluate the ability of four objectively defined, cortical maturation features—surface area, gyrification index, sulcal depth and curvature—from structural MRI at term-equivalent age (TEA) to independently predict cognitive and language development at 2 years corrected age in very preterm (VPT) infants.DesignPopulation-based, prospective cohort study. Structural brain MRI was performed at term, between 40 and 44 weeks postmenstrual age and processed using the developing Human Connectome Project pipeline.SettingMulticentre study comprising four regional level III neonatal intensive care units in the Columbus, Ohio region.Patients110 VPT infants (gestational age (GA) ≤ 31 weeks).Main outcome measuresCognitive and language scores at 2 years corrected age on the Bayley Scales of Infant and Toddler Development, Third Edition.ResultsOf the 94 VPT infants with high-quality T2-weighted MRI scans, 75 infants (80%) returned for Bayley-III testing. Cortical surface area was positively correlated with cognitive and language scores in nearly every brain region. Curvature of the inner cortex was negatively correlated with Bayley scores in the frontal, parietal and temporal lobes. In multivariable regression models, adjusting for GA, sex, socioeconomic status, and injury score on MRI, regional measures of surface area and curvature independently explained more than one-third of the variance in cognitive and language scores at 2 years corrected age in our cohort.ConclusionsWe identified increased cortical curvature at TEA as a new prognostic biomarker of adverse neurodevelopment in very premature infants. When combined with cortical surface area, it enhanced prediction of cognitive and language development. Larger studies are needed to externally validate our findings.

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