scholarly journals Language, Motor, and Cognitive Outcomes of Toddlers Who Were Born Preterm

2020 ◽  
Vol 29 (2) ◽  
pp. 625-637
Author(s):  
Diane Frome Loeb ◽  
Caitlin M. Imgrund ◽  
Jaehoon Lee ◽  
Steven M. Barlow
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Lung Disease ◽  
Preterm Infant ◽  
Chronic Lung Disease ◽  
Maternal Education ◽  
Distress Syndrome ◽  
Cognitive Outcomes ◽  
Language Delays ◽  
Diabetic Mothers

Purpose The purpose of this study was to examine the language, motor, and cognitive abilities of children born preterm in four categories: (a) healthy preterm infants, (b) infants of diabetic mothers, (c) infants with respiratory distress syndrome, and (d) infants with chronic lung disease when the children were 30 months, uncorrected age. Comorbidity of language, motor, and cognitive skills was examined, along with predictor variables. Method A total of 148 children who were born preterm participated and were assessed using bivariate tests and logistic regression on standardized assessment scores. Results Controlling for the children's gestational age (GA), overall language ability was significantly lower in the infants of diabetic mothers group compared to the healthy preterm infant group, and expressive language skills were significantly lower for the chronic lung disease group than the respiratory distress syndrome group. The children with language delays on at least one measure were significantly more likely to have cognitive, motor, or both delays. Lower maternal education was a significant predictor for language and cognitive delays, and younger GA was a significant predictor for language, motor, and cognitive delays. Conclusion Assessment of the preterm infant from a biosystems approach allows the speech-language pathologist to take into consideration maternal education, diagnosis at preterm birth, and GA, which were found to impact the language, motor, and cognitive outcomes of children born preterm. Our findings further reinforce the concept of the whole child in that children born preterm who display language delays should be screened for co-occurring motor and/or cognitive delays.

Prospective Randomized Comparison of High-Frequency Oscillatory and Conventional Ventilation in Respiratory Distress Syndrome

PEDIATRICS ◽  
1992 ◽  
Vol 89 (1) ◽  
pp. 5-12
Author(s):  
Reese H. Clark ◽  
Donald M. Null ◽  
Dale R. Gerstmann ◽  
Robert A. deLemos
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
High Frequency ◽  
Distress Syndrome ◽  
Efficacy And Safety ◽  
Intermittent Mandatory Ventilation ◽  
The Difference ◽  
High Frequency Oscillatory

A prospective randomized trial with a crossover design was conducted to compare the efficacy and safety of two distinct strategies of high-frequency oscillatory ventilation (HFOV) to conventional intermittent mandatory ventilation (CV) in the management of respiratory distress syndrome. Only premature neonates with a birth weight less than 1.751 kg were eligible for enrollment into the study. Of 83 patients studied, 26 patients were assigned to CV-only, 27 to HFOV for 72 hours followed by CV (HFOV/CV), and 30 to HFOV-only until extubation. There was no difference among the three groups with respect to the incidence of pulmonary airleak, intraventricular hemorrhage, or death. The highest incidence of chronic lung disease was in the CV-only group. Although both HFOV groups had a lower incidence of chronic lung disease assessed at 30 days and 36weeks postconception age, the difference was statistically significant only between the CV-only and HFOV-only groups (65% vs 30% at 30 days; P = .008; 38% vs 10% at 36 weeks postconception age, P = .013). These results suggest that use of HFOV as the predominant mode of ventilation in the management of respiratory distress syndrome is as safe as CV and can contribute to a decreased incidence of chronic lung disease. Furthermore, a short (72-hour) period of HFOV support does not provide the same advantage as continuous HFOV.

Statistical Overkill: Shooting at Jack Rabbits With a Cannon

PEDIATRICS ◽  
1988 ◽  
Vol 81 (6) ◽  
pp. 914-914
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Distress Syndrome ◽  
Disease Outcome ◽  
Statistical Attack ◽  
Clinical Events

To the Editor.— The weakness of associations found in descriptive surveys of past clinical events is self-evident, but these searches sometimes turn up testable questions. Why then did your correspondents1 think it necessary to wheel out heavy statistical artillery to shoot down the shaky numbers generated in the between-hospital comparisons2 of chronic lung disease outcome after different management of respiratory distress syndrome? It will be unfortunate if the statistical attack is taken as conclusive refutation.

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