Neurodevelopmental outcomes following preterm birth and the association with postmenstrual age at discharge

2022 ◽  
Author(s):  
Polly Kellner ◽  
Jenny Kwon ◽  
Joan Smith ◽  
Roberta G Pineda
Keyword(s):  
Risk Factors ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Neurodevelopmental Outcome ◽  
Cognitive Outcome ◽  
Composite Score ◽  
Neurodevelopmental Outcomes ◽  
Medical Risk ◽  
Medical Risk Factors ◽  
Postmenstrual Age

Objective: To 1) define the prevalence of motor, cognitive, and language delays in preterm infants born < 32 weeks estimated gestational age (EGA) and 2) identify the relationship between the timing of discharge from the NICU and neurodevelopmental outcome in early childhood. Study Design: This retrospective study of 176 preterm infants born < 32 weeks EGA and hospitalized in a level IV NICU captured medical factors, including timing of discharge, from the NICU stay. Standardized developmental testing at 1-2 years corrected age was conducted in the newborn follow-up clinic. Results: At 1-2 years corrected age, the sample had an average cognitive composite score of 91.5 ± 17.4, language composite score of 84.5 ± 17.3, and motor composite score of 88.9 ± 18.4. Lower EGA at birth, necrotizing enterocolitis, patent ductus arteriosus, and oxygen requirement for > 28 days were independently associated with higher postmenstrual age (PMA) at NICU discharge. After controlling for known risk factors, higher PMA at discharge was associated with poorer cognitive outcome [p < 0.001, (-0.16, -0.07), β = -0.35], poorer language outcome [p = 0.049 (-0.10, 0.00), β = -0.15] and poorer motor outcome [p < 0.001, (-0.14, -0.05), β = -0.30]. Conclusion: Poorer cognitive, language, and motor outcomes were associated with longer hospitalization, even after controlling for medical risk factors known to be associated with poorer outcome. This provides further evidence for the potential role of the environment that may be impacting the developmental outcomes of infants hospitalized in the NICU.

Delayed Achievement of Oral Feedings Is Associated with Adverse Neurodevelopmental Outcomes at 18 to 26 Months Follow-up in Preterm Infants

2019 ◽  
Vol 37 (05) ◽  
pp. 483-490 ◽  
Author(s):  
Shabnam Lainwala ◽  
Natalia Kosyakova ◽  
Kimberly Power ◽  
Naveed Hussain ◽  
James E. Moore ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Retrospective Study ◽  
Preterm Infants ◽  
Neurodevelopmental Outcome ◽  
Oral Intake ◽  
Neurodevelopmental Outcomes ◽  
Motor Delay ◽  
Postmenstrual Age ◽  
Multivariable Analyses

Abstract Objective This study aimed to compare neurodevelopmental outcomes in preterm infants at 18 to 26 months corrected age (CA) who did versus did not achieve full oral feedings at 40 weeks postmenstrual age (PMA). Study Design This retrospective study included infants born between 2010 and 2015 with gestational age <32 weeks and followed between 18 and 26 months CA. Achievement of full oral feedings was defined as oral intake >130 mL/kg/d for >72 hours by 40 weeks PMA. Incidence of cognitive, language, or motor delay, or cerebral palsy at 18 to 26 months CA was compared in multivariable analyses for infants in the two feeding groups. Results Of 372 included infants, those achieving full oral feedings had lower incidence of any adverse neurodevelopmental outcome (p < 0.001) compared with those who did not achieve full oral feedings. In multivariable analyses, achievement of full oral feedings by 40 weeks PMA was associated with decreased odds of cognitive, language, and motor delays, cerebral palsy, and any adverse neurodevelopmental outcome at follow-up. Conclusion Achievement of full oral feedings by 40 weeks PMA was associated with better adjusted neurodevelopmental outcomes at 18 to 26 months CA. Inability to fully feed orally at 40 weeks PMA may be a simple, clinically useful marker for risk of adverse neurodevelopmental outcomes.

Infant EEG Spectral Coherence Data during Quiet Sleep: Unrestricted Principal Components Analysis — Relation of Factors to Gestational Age, Medical Risk, and Neurobehavioral Status

2003 ◽  
Vol 34 (2) ◽  
pp. 54-69 ◽  
Author(s):  
Frank H. Duffy ◽  
Heidelise Als ◽  
Gloria B. McAnulty
Keyword(s):  
Risk Factors ◽  
Principal Components Analysis ◽  
Gestational Age ◽  
Principal Components ◽  
Spectral Coherence ◽  
Quiet Sleep ◽  
Medical Risk ◽  
Medical Risk Factors ◽  
Components Analysis ◽  
Coherence Factors

EEG spectral coherence data in quiet sleep of 312 infants were evaluated, at 42 weeks post-menstrual age. All were medically healthy and living at home by time of evaluation. The sample consisted of prematurely born infants with a wide spectrum of underlying risk factors, as well as healthy fullterm infants. Initial 3040 coherence variables were reduced by principal components analysis in an unrestricted manner, which avoided the folding of spectral and spatial information into among-subject variance. One hundred fifty factors explained 90% of the total variance; 40 Varimax rotated factors explained 65% of the variance yielding a 50:1 data reduction. Factor loading patterns ranged from multiple spectral bands for a single electrode pair to multiple electrode pairs for a single spectral band and all intermediate possibilities. Simple left-right and anterior-posterior pairings were not observed within the factor loadings. By multiple regression analysis, the 40 factors significantly predicted gestational age at birth. By canonical correlation, significant relationships were demonstrated between the coherence factors and medical risk factors as well as neurobehavioral factors. Using discriminant analysis, the coherence factors successfully discriminated between infants with high and low medical risk status and between those with the best and worst neurobehavioral status. The two factors accounting for the most variance, and chosen across several analyses, indicated increased left central-temporal coherence from 6–24 Hz, and increased frontal-occipital coherence at 10 Hz, for the infants born closest to term with lowest medical risk factors and best neurobehavioral performance.

Fetal macrosomia: obstetrical, psychological and social aspects

2018 ◽  
pp. 36-39
Author(s):  
S.I. Zhuk ◽  
◽  
O.D. Shchurevska ◽  
Keyword(s):  
Risk Factors ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Psychosocial Stress ◽  
Fetal Macrosomia ◽  
Medical Problems ◽  
Medical Risk ◽  
Pregnancy And Childbirth ◽  
Medical Risk Factors ◽  
Forced Migrants

One of the main markers of socially unfavorable pregnancy is anthropometric indicators of newborns. They reflect not only the narrow medical problems of complicated gestation but also social problems in general, the quality and access to the medical care. The objective: to determine the risk factors for fetal macrosomia in pregnancy with high levels of psychosocial stress. Materials and methods. The course of pregnancy and childbirth, demographic and medical risk factors for a fetal macrosomia were analyzed in 140 pregnant women with different levels of psychosocial stress. They were divided into 2 groups: 1 group (main) – 56 women-forced migrants from Luhansk and Donetsk regions, 2 group – 84 women with low and moderate level stress according to the questionnaires and psychological tests (L. Reeder, Spielberg–Khanin scale). Results. Gestational diabetes was the main reason for the birth of heavy children in both groups. Women–forced migrants had late manifestation of impaired tolerance to carbohydrates and a higher frequency of pathological weight gain. Male neonates are at risk for macrosomia. Childbirth in women with macrosomia is accompanied by a high frequency of complications and abnormal births. Conclusions. The frequency of births of macrosomic children in women - forced migrants is higher than in women at low risk of psychosocial stress. Risk factors in this group of pregnants include: the level of stress and behavioral responses to stress, impaired carbohydrate tolerance due to gestational diabetes, abnormal weight gain due to malnutrition and male sex of the fetus. Keywords: macrosomia, pregnancy, childbirth, women–forced migrants psychosocial stress, gestational diabetes, weight gain.

scholarly journals Investigation of the Adherence to Prescribed Treatment of the Patients with Coronary Heart Disease

2021 ◽  
Vol 6 (5) ◽  
pp. 263-269
Author(s):  
V. O. Shuper ◽  
◽  
S. V. Shuper ◽  
I. V. Trefanenko ◽  
G. I. Shumko ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Secondary Prevention ◽  
Cardiovascular Mortality ◽  
Healthcare Professionals ◽  
Complete Information ◽  
Cardiovascular Death ◽  
Medical Risk ◽  
Medical Risk Factors

The purpose of the study was to investigate the adherence to secondary prevention medications among patients with coronary heart disease and identify factors associated with it. Materials and methods. We examined 40 patients diagnosed with coronary heart disease of more than 50 years old, who were prescribed with optimal medication for 1 year during hospitalization. Patients` adherence was defined according to MMS-8 Morisky values for secondary prevention medications prescribed by doctors. Also, questionnaires about individual reasons of non-compliance and for individual patient`s opinion about importance and usefulness of knowledge according to risk factors of the increase of cardiovascular mortality were designed and proposed to the patients. Simple descriptive statistics were used to elucidate the characteristics of the patient population and results from individual adherence tools. Final score was analyzed and correlation between patients’ data and level of adherence to prescribed treatment were identified. A correlation matrix (using Spearman’s coefficient) was reviewed for any evidence of collinearity. Results and discussion. Our study demonstrated higher level of non-adherence with secondary prevention medications in patients with coronary heart disease (60.0%). This fact can be explained by the socioeconomic reasons, less informative strategies from the medical staff to the patients. Severe regress of adherence was demonstrated after discharge from the hospital due to subjective improvement of the patients` condition with absence of supervision by out-patient specialists. Demographic characteristics of the patients suggested that some non-modified factors can affect compliance with the prescribed treatment. Better adherence was demonstrated by female married patients with higher educational level, with family history about cardiovascular death. Also, too much prescribed medications with difficult regime of usage with non-adequate out-patient supervision may significantly decrease adherence causing development of complications which may lead to re-hospitalizations and cardiovascular death. Our investigation demonstrated also non-complete information of the patients about lifestyle and medical risk factors of the cardiovascular mortality increase. Conclusion. The results of our study can provide useful practical information on the prevalence and severity of non-adherence among patients with coronary heart disease. Analysis of the factors influencing the adherence demonstrated the main reasons from patients and healthcare professionals affecting the level of compliance with the prescribed treatment. The step towards improving adherence can be initiated by the healthcare professional to overcome the patient's concerns about the prescribed medication. It is important to continue personal monitoring of patients by healthcare professionals in the form of regular inspections of intentional and unintentional non-adherence, including factors and reasons that may change and lead to such behavior

scholarly journals Medical risk factors and the development of brain tumors

Cancer ◽  
1992 ◽  
Vol 69 (10) ◽  
pp. 2541-2547 ◽  
Author(s):  
Brigitte Schlehofer ◽  
Maria Blettner ◽  
Nikolaus Becker ◽  
Christine Martinsohn ◽  
Jiirgen Wahrendorf
Keyword(s):  
Risk Factors ◽  
Brain Tumors ◽  
Medical Risk ◽  
Medical Risk Factors

One-year neurodevelopmental outcome of very and late preterm infants: Risk factors and correlation with maternal stress

2015 ◽  
Vol 39 ◽  
pp. 11-20 ◽  
Author(s):  
Maria Franca Coletti ◽  
Barbara Caravale ◽  
Corinna Gasparini ◽  
Francesco Franco ◽  
Francesca Campi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Infants ◽  
Maternal Stress ◽  
Neurodevelopmental Outcome ◽  
Late Preterm ◽  
Late Preterm Infants ◽  
One Year
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