Correlation between Perfusion Index and Left Ventricular Output in Healthy Late Preterm Infants

Aim The perfusion index (PI) is a noninvasive marker derived from photoelectric plethysmographic signals in pulse oximetry in the evaluation of peripheral perfusion. This study was aimed to determine the correlation between PI and left ventricular output (LVO) in healthy late preterm infants at 48th hour of life. Methods With new generation pulse oximeter (MASIMO Rad 7 Oximeter) pre- and post-ductal PI values were recorded from healthy late preterm babies at the 48th hour of life. PI was determined simultaneously with LVO as measured by transthoracic echocardiography. Results A total of 50 late preterm babies were included in the study. The mean gestational age of the cases was 35.4 ± 0.7 weeks and the birth weight was 2,586 ± 362 g. Mean pre- and post-ductal PI values at the postnatal 48th hour of babies' life were found to be 2.0 ± 0.9 and 1.7 ± 1.1. The mean LVO value was 438 ± 124, LVO/kg 175 ± 50. When the LVO value was normalized according to the babies' body weight, there was no statistically significant correlation between the pre- and post-ductal PI and the LVO/kg value (r <0.2, p >0.05 in both comparisons). Conclusion There was no correlation between pre- and post-ductal PI and LVO values in healthy late preterm infants. This may be due to the failure of the LVO, a systemic hemodynamic parameter, to accurately reflect microvascular blood flow due to incomplete maturation of the sympathetic nervous system involved in the regulation of peripheral tissue perfusion in preterm babies. Key Points

Download Full-text

Correlation between Perfusion Index and Left Ventricular Output in Healthy Late Preterm Infants

10.21203/rs.3.rs-519041/v1 ◽

2021 ◽

Author(s):

Nilay Hakan ◽

Ayça Aytekin ◽

Özkan İlhan ◽

Mustafa Aydin ◽

Haşim Olgun

Keyword(s):

Preterm Infants ◽

Left Ventricular ◽

Perfusion Index ◽

Late Preterm ◽

Microvascular Blood Flow ◽

Systemic Hemodynamic ◽

Late Preterm Infants ◽

Preterm Babies ◽

Left Ventricular Output ◽

The Mean

Abstract The perfusion index (PI) is a noninvasive marker derived from photoelectric plethysmographic signals in pulse oximetry in the evaluation of peripheral perfusion. This study was aimed to determine the correlation between PI and left ventricular output (LVO) in healthy late preterm infants at 48th hour of life. With new generation pulse oximeter [MASIMO Rad 7 Oximeter] pre- and post-ductal PI values were recorded from healthy late preterm babies at the 48th hour of life. PI was determined simultaneously with LVO as measured by transthoracic echocardiography. A total of 50 late preterm babies were included in the study. The mean gestational age of the cases was 35.4 ± 0.7 weeks and the birth weight was 2586 ± 362 g. Mean pre- and post-ductal PI values at the postnatal 48th hour of babies’ life were found to be 2.0 ± 0.9 and 1.7 ± 1.1. The mean LVO value was 438 ± 124, LVO/kg 175 ± 50. When the LVO value was normalized according to the babies’ body weight, there was no statistically significant correlation between the pre- and post-ductal PI and the LVO / kg value (r < 0.2, p > 0.05 in both comparisons). Conclusion: There was no correlation between pre- and post-ductal PI and LVO values in healthy late preterm infants. This may be due to the failure of the LVO, a systemic hemodynamic parameter, to accurately reflect microvascular blood flow due to incomplete maturation of the sympathetic nervous system involved in the regulation of peripheral tissue perfusion in preterm babies.

Download Full-text

Myocardial function in late preterm infants during the transitional period: comprehensive appraisal with deformation mechanics and non-invasive cardiac output monitoring

Cardiology in the Young ◽

10.1017/s1047951119003020 ◽

2019 ◽

Vol 30 (2) ◽

pp. 249-255

Author(s):

Alessia Cappelleri ◽

Neidin Bussmann ◽

Susan Harvey ◽

Phillip T. Levy ◽

Orla Franklin ◽

...

Keyword(s):

Cardiac Output ◽

Stroke Volume ◽

Preterm Infants ◽

Left Ventricular ◽

Late Preterm ◽

Cardiac Output Monitoring ◽

Late Preterm Infants ◽

Non Invasive ◽

Left Ventricular Output ◽

Output Monitoring

AbstractBackground:There is a paucity of functional data on mid-to-late preterm infants between 30+0 and 34+6 weeks gestation. We aimed to characterise transitional cardiopulmonary and haemodynamic changes during the first 48 hours in asymptomatic mid-to-late preterm infants.Methods:Forty-five healthy preterm newborns (mean ± standard deviation) gestation of 32.7 ± 1.2 weeks) underwent echocardiography on Days 1 and 2. Ventricular mechanics were assessed by speckle tracking-derived deformation, rotational mechanics, tissue Doppler imaging, and right ventricle-focused measures (tricuspid annular plane systolic excursion, fractional area change). Continuous haemodynamics were assessed using the NICOM™ system to obtain left ventricular output, stroke volume, heart rate, and total peripheral resistance by non-invasive cardiac output monitoring.Results:Right ventricular function increased (all measures p < 0.005) with mostly stable left ventricular performance between Day 1 and Day 2. NICOM-derived left ventricular output [mean 34%, 95% confidence interval 21–47%] and stroke volume [29%, 16–42%] increased with no change in heart rate [5%, −2 to 12%]. There was a rise in mean blood pressure [11%, 1–21%], but a decline in total peripheral resistance [−14%, −25 to −3%].Conclusion:Left ventricular mechanics remained persevered in mid-to-late premature infants, but right ventricular function increased. Non-invasive cardiac output monitoring is feasible in preterm infants with an increase in left ventricular output driven by an improvement in stroke volume during the transitional period.

Download Full-text

Long-term cognitive, executive, and behavioral outcomes of moderate and late preterm at school age

Clinical and Experimental Pediatrics ◽

10.3345/kjp.2019.00647 ◽

2020 ◽

Vol 63 (6) ◽

pp. 219-225 ◽

Cited By ~ 2

Author(s):

Ju Hyun Jin ◽

Shin Won Yoon ◽

Jungeun Song ◽

Seong Woo Kim ◽

Hee Jung Chung

Keyword(s):

Executive Function ◽

Preterm Infants ◽

Behavioral Problems ◽

Chromosomal Abnormalities ◽

Attention Problems ◽

Late Preterm ◽

School Age ◽

Late Preterm Infants ◽

The Mean ◽

Borderline Intelligence

Background: There is increasing concern that moderate preterm (32–33 weeks’ gestation) and late preterm (34–36 weeks’ gestation) birth may be associated with minor neurodevelopmental problems affecting poor school performance.Purpose: We explored the cognitive function, cognitive visual function, executive function, and behavioral problems at schoolage in moderate to late preterm infants.Methods: Children aged 7–10 years who were born at 32+0 to 36+6 weeks of gestation and admitted to the neonatal intensive care unit from August 2006 to July 2011 at the National Health Insurance Service Ilsan Hospital were included. We excluded children with severe neurologic impairments, congenital malformations, or chromosomal abnormalities. Neuropsychological assessments consisted of 5 neuropsychological tests and 3 questionnaires.Results: A total of 37 children (mean age, 9.1±1.2 years) participated. The mean gestational age at birth was 34.6±7.5 weeks, while the mean birth weight was 2,229.2±472.8 g. The mean full-scale intelligence quotient was 92.89±11.90; 24.3% scored between 70 and 85 (borderline intelligence functioning). An abnormal score was noted for at least one of the variables on the attention deficit hyperactivity disorder diagnostic system for 65% of the children. Scores below borderline function for executive quotient and memory quotient were 32.4% and 24.3%, respectively. Borderline or clinically relevant internalizing problems were noted in 13.5% on the Child Behavior Check List. There were no significant associations between perinatal factors or socioeconomic status and cognitive, visual perception, executive function, or behavior outcomes.Conclusion: Moderate to late preterm infants are at risk of developing borderline intelligence functioning and attention problems at early school age. Cognitive and executive functions that are important for academic performance must be carefully monitored and continuously followed up in moderate to late preterm infants.

Download Full-text

Breastfeeding Self-Efficacy and Its Relationship with the Perceived Stress and the Breastfeeding Performance in Iranian Mothers with Late Preterm Infants, 2019

10.21203/rs.3.rs-87806/v1 ◽

2020 ◽

Author(s):

Akram Kahforoushan ◽

Shirin Hasanpour ◽

Mojgan Mirghafourvand

Keyword(s):

Standard Deviation ◽

Linear Regression ◽

Multiple Linear Regression ◽

Preterm Infants ◽

Perceived Stress ◽

Self Efficacy ◽

Short Form ◽

Late Preterm ◽

Late Preterm Infants ◽

The Mean

Abstract BackgroundLate preterm infants suffer from many short-term and long-term problems after birth. The key factor in fighting these problems is effective breastfeeding. The present study aimedto determine the breastfeeding self-efficacy and its relationship with the perceived stress and breastfeeding performance in mothers with late preterm infants. MethodsIn this prospective study, 171 nursing mothers with late preterm infants born in Alzahra Medical Center of Tabriz, Iran, who met the conditions of this study were selected through convenience sampling. The Breastfeeding Self-Efficacy Scale-Short Form (BSES- SF) was employed to measure breastfeeding self-efficacy and 14-item Perceived Stress Scale (PSS14) was used to measure the perceived stress during 24 hours after giving birth and when the child was 4 months old the breastfeeding performance was measured by the standard breastfeeding performance questionnaire. The data were analyzed by Pearson and Spearman’s correlation tests, independent t-test, one-way ANOVA, and Multiple Linear Regression.ResultsThe mean (standard deviation) of breastfeeding self-efficacy equaled 50.0 (7.8) from the scores ranging between13-65 and the mean (standard deviation) of the perceived stress equaled to 26.5 (8.8) from the scores ranging between 0-56. The median (25-75 percentiles) of breastfeeding performance score in the mothers equaled 2.0 (1.0 to 3.0) from the scores ranging between 0-6. On the basis of multiple linear regression and through adjusting the personal-social characteristic, by increasing the score of the breastfeeding self-efficacy, the perceived stress was decreased to a statistically significant amount (B=-0.1, 95%CI=-0.3 to 0.0), however, there was no statistically significant relationship between breastfeeding self-efficacy and breastfeeding performance (p=0.418). ConclusionDue to the modifiable variability of breastfeeding self-efficacy and its role in perceived maternal stress, the development of appropriate strategies to further increase breastfeeding self-efficacy and provide more support to these mothers and infants is of particular importance.

Download Full-text

Oxygen saturation and heart rate in healthy term and late preterm infants with delayed cord clamping

Pediatric Research ◽

10.1038/s41390-021-01805-y ◽

2022 ◽

Author(s):

Inmaculada Lara-Cantón ◽

Shiraz Badurdeen ◽

Janneke Dekker ◽

Peter Davis ◽

Calum Roberts ◽

...

Keyword(s):

Oxygen Saturation ◽

Preterm Infants ◽

Left Ventricular ◽

Late Preterm ◽

Arterial Oxygen ◽

Reference Ranges ◽

Delayed Cord Clamping ◽

Late Preterm Infants ◽

Cord Clamping ◽

Neonatal Transition

Abstract Blood oxygen in the fetus is substantially lower than in the newborn infant. In the minutes after birth, arterial oxygen saturation rises from around 50–60% to 90–95%. Initial respiratory efforts generate negative trans-thoracic pressures that drive liquid from the airways into the lung interstitium facilitating lung aeration, blood oxygenation, and pulmonary artery vasodilatation. Consequently, intra- (foramen ovale) and extra-cardiac (ductus arteriosus) shunting changes and the sequential circulation switches to a parallel pulmonary and systemic circulation. Delaying cord clamping preserves blood flow through the ascending vena cava, thus increasing right and left ventricular preload. Recently published reference ranges have suggested that delayed cord clamping positively influenced the fetal-to-neonatal transition. Oxygen saturation in babies with delayed cord clamping plateaus significantly earlier to values of 85–90% than in babies with immediate cord clamping. Delayed cord clamping may also contribute to fewer episodes of brady-or-tachycardia in the first minutes after birth, but data from randomized trials are awaited. Impact Delaying cord clamping during fetal to neonatal transition contributes to a significantly earlier plateauing of oxygen saturation and fewer episodes of brady-and/or-tachycardia in the first minutes after birth. We provide updated information regarding the changes in SpO2 and HR during postnatal adaptation of term and late preterm infants receiving delayed compared with immediate cord clamping. Nomograms in newborn infants with delayed cord clamping will provide valuable reference ranges to establish target SpO2 and HR in the first minutes after birth.

Download Full-text

Early skin-to-skin contact between healthy late preterm infants and their parents: an observational cohort study

PeerJ ◽

10.7717/peerj.3949 ◽

2017 ◽

Vol 5 ◽

pp. e3949 ◽

Cited By ~ 3

Author(s):

Kerstin H. Nyqvist ◽

Andreas Rosenblad ◽

Helena Volgsten ◽

Eva-Lotta Funkquist ◽

Elisabet Mattsson

Keyword(s):

Cohort Study ◽

Preterm Infants ◽

Linear Regression Analysis ◽

Observational Cohort Study ◽

Late Preterm ◽

Late Preterm Infants ◽

Skin Contact ◽

Observational Cohort ◽

The Mean ◽

Skin To Skin

Background Skin-to-skin contact (SSC) is an important factor to consider in the care of late preterm infants (born between 34 0/7 and 36 6/7 completed weeks of gestation). The literature suggests that SSC between preterm infants and their mothers facilitates breastfeeding. However, more studies are needed to explore potential dose-response effects between SSC and breastfeeding as well as studies that explicitly investigate SSC by fathers among late preterm infants. The aim was to investigate the duration of healthy late preterm infants’ SSC with the mother and father, respectively, during the first 48 h after birth and the associations with breastfeeding (exclusive/partial at discharged), clinical and demographic variables. Methods This was an observational cohort study in which parents to healthy late preterm infants, born between 34 5/7 and 36 6/7 completed weeks of gestation, recorded duration of SSC provided by mother and father, respectively. Demographic and clinical variables were retrieved from the medical records and were used as predictors. Multiple linear regression analysis was used to assess the association between the predictors and the outcome, SSC (hours), separately for mothers and fathers. Results The mean (standard deviation [SD]) time per day spent with SSC with mothers (n = 64) and fathers (n = 64), was 14.7 (5.6) and 4.4 (3.3) hours during the first day (24 h) after birth and 9.2 (7.1) and 3.1 (3.3) hours during the second day (24 h), respectively. Regarding SSC with mothers, no variable was significantly associated with SSC during the first day, while the mean (95% confidence interval [CI]) time of SSC during the second day was 6.9 (1.4–12.4) hours shorter for each additional kg of birthweight (p = 0.014). Concerning SSC with fathers, the mean (95% CI) time of SSC during the first day was 2.1 (0.4–3.7) hours longer for infants born at night (p = 0.015), 1.7 (0.1–3.2) hours longer for boys (p = 0.033), 3.2 (1.2–5.2) hours longer for infants born by caesarean section (p = 0.003), and 1.6 (0.1–3.1) hours longer for infants exclusively breastfed at discharge (p = 0.040). During the second day, the mean (95% CI) time of SSC with fathers was 3.0 (0.6–5.4) hours shorter for each additional kg of birthweight (p = 0.014), 2.0 (0.5–3.6) hours longer for infants born during night-time (p = 0.011), 2.9 (1.4–4.4) hours longer if the mother was primipara (p < 0.001), and 1.9 (0.3–3.5) hours shorter if supplementary artificial milk feeds were given. None of the other predictors, i.e., mother’s age, gestational age, or induction of labor were significantly associated with infants’ SSC with mothers or fathers during any of the first two days after birth. Conclusion Future studies are warranted that investigate duration of SSC between late preterm infants and their parents separately and the associations with breastfeeding and other variables of clinical importance.

Download Full-text

Duration of Breastfeeding in Late Preterm Infants: Maternal and Infant Factors

Journal of Human Lactation ◽

10.1177/0890334420978380 ◽

2020 ◽

pp. 089033442097838

Author(s):

Kartika Darma Handayani ◽

Irwanto ◽

Melinda Masturina ◽

Risa Etika ◽

Agus Harianto ◽

...

Keyword(s):

Preterm Infants ◽

Self Efficacy ◽

Assessment Tool ◽

Short Form ◽

Late Preterm ◽

Maternal Factors ◽

Term Infants ◽

Late Preterm Infants ◽

The Mean ◽

Duration Of Breastfeeding

Background More than 550,000 late preterm infants are born each year in Indonesia. These infants, born between 340/7–366/7 weeks, have more complications than term infants. Breastfeeding is considered the most optimal nutrition for newborn infants. Two groups of factors are important for successful breastfeeding: infant and maternal factors. The infant factors can be evaluated using the Infant Breastfeeding Assessment Tool and the maternal aspects with the Breastfeeding Self-Efficacy Scale–Short Form. Aim To determine whether the Infant Breastfeeding Assessment Tool or the Breastfeeding Self-Efficacy Scale–Short Form was more predictive of successful breastfeeding among late preterm infants. Methods This study was conducted in the Academic Teaching Hospital in Surabaya, Indonesia in March–July 2017. Mothers who delivered their infant between a gestational age of 340/7 and 366/7 weeks were included. Results Fifty-four single born participant mother–infant pairs were included. The mean total Breastfeeding Self-Efficacy Scale–Short Form score was 57.8 ( SD = 8.9). The mean Infant Breastfeeding Assessment Tool score was 8.3 ( SD = 1.8). There was a significant correlation between the total Breastfeeding Self-Efficacy Scale–Short Form score and the Infant Breastfeeding Assessment Tool score ( p = .020, r = 0.316). The Breastfeeding Self-Efficacy Scale–Short Form was significantly higher in the participant (mothers) of the infants breastfed ≥ 4 months, compared to < 4 months, 61.59 ( SD = 5.78) versus 51.78 ( SD = 11.64; p = .001). No correlation was found between the duration of breastfeeding and Infant Breastfeeding Assessment Tool score ( p = .087) Conclusion Maternal factors were more important for successful breastfeeding in these late preterm infants than infant factors in our sample.

Download Full-text

Early neonatal morbidities in late preterm compared to term neonates born in a tertiary care private hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20200680 ◽

2020 ◽

Vol 7 (3) ◽

pp. 565

Author(s):

Yogesh P. Mehta ◽

Manjusha Bhicurao Naik ◽

Kinnera Putrevu

Keyword(s):

Preterm Infants ◽

Tertiary Care ◽

Full Term ◽

Late Preterm ◽

Term Infants ◽

Term Neonates ◽

Late Preterm Infants ◽

Increased Risk ◽

Preterm Babies ◽

Term Newborns

Background: Late preterm babies, born between 34 completed weeks of gestation through 36 weeks 6/7 gestation, tend to be physiologically less mature than term infants, subjecting them to an increased risk of developing various morbidities. Limited information is available regarding the current scenario in India. Therefore, the objective of this study was to understand and compare the early morbidities in late preterm newborns with those in full term babies in a tertiary hospital in India.Methods: The current prospective, observational study consisted of total 150 babies divided into two groups equally; late preterm neonates born between 34 and 36 weeks of gestation and full-term neonates. Weight (at birth, at 72 hours), heart rate, temperature and respiratory parameters were noted of all babies. The newborns were examined for respiratory morbidities, ability to breastfeed, hypoglycemia, hypothermia, neonatal jaundice and signs of sepsis. The need for resuscitation, admission to neonatal intensive care unit (NICU) and parenteral nutrition was also assessed. Data was expressed as mean±SD and was analyzed using the Student ‘t’ and Mann Whitney U tests.Results: The mean length and weight at birth in late preterm babies was significantly lesser than term newborns. Late preterm babies were found to have significantly higher incidence of complications like hyperbilirubinemia (62.7% vs 13.3%), respiratory morbidities (16% vs 4%), poor feeding, hypothermia, hypoglycemia, and sepsis compared to term newborns (p<0.01).Conclusions: Late preterm infants are at a higher risk than term infants for a number of neonatal complications. Initiatives imparting special care to late preterm infants are required in order to lower the morbidities endured by this population.

Download Full-text

Morbidity and Mortality Profile of Late Preterm Neonates as Compared to Term Neonates from a Tertiary Care Centre in Silchar

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/458 ◽

2021 ◽

Vol 10 (30) ◽

pp. 2239-2243

Author(s):

Pranav N. Saji ◽

Anupama Deka

Keyword(s):

Preterm Infants ◽

Late Preterm ◽

Morbidity And Mortality ◽

Preterm Neonates ◽

Term Infants ◽

Term Neonates ◽

Maternal Risk ◽

Late Preterm Infants ◽

Increased Risk ◽

Preterm Babies

BACKGROUND Late preterm infants are less mature physiologically and have poor compensatory responses when compared to term infants. Recent studies have implied increased morbidities in late preterm infants and higher rate of hospital admission during neonatal period. Multiple maternal risk factors lead to the increasing incidence of late preterm births. We wanted to study the morbidity and mortality profile of late preterm infants compared to term infants. METHODS The study was conducted in the special newborn care unit (SCNU) of Silchar Medical College and Hospital. The study population comprised of 175 late preterm and 175 term babies admitted in SCNU. It was a cross sectional study. RESULTS In this study 175 late preterm neonates were compared with 175 term neonates. Late preterm babies were at increased risk of hypoglycemia (P value = 0.0130), neonatal jaundice (P = 0.021), culture positive sepsis (P = 0.001), respiratory distress (P = 0.000), hypocalcaemia (P = 0.030), difficulty in feeding (P = 0.000) and birth asphyxia (P = 0.013), longer hospital stay and mortality (P = 0.009) when compared to term babies. In babies of mothers with oligohydramnios and pregnancy induced hypertension, preterm babies had significant morbidity compared to term babies. CONCLUSIONS Late preterm babies have an increased risk of morbidity and mortality when compared to term neonates and need special care. Premature rupture of membranes, antepartum hemorrhage and pre-eclampsia are the main maternal complications leading to premature delivery of the baby. KEY WORDS Late Preterm, Preeclampsia, Oligohydramnios, Morbidity

Download Full-text

Breastfeeding Self-Efficacy and Its Relationship with Perceived Stress and Breastfeeding Performance in Iranian Mothers with Late Preterm Infants: A Prospective Study

Current Women s Health Reviews ◽

10.2174/1573404817666211124102128 ◽

2021 ◽

Vol 17 ◽

Author(s):

Akram Kahforoushan ◽

Shirin Hasanpour ◽

Mojgan Mirghafourvand

Keyword(s):

Regression Analysis ◽

Standard Deviation ◽

Preterm Infants ◽

Perceived Stress ◽

Self Efficacy ◽

Linear Regression Analysis ◽

Multiple Linear Regression Analysis ◽

Late Preterm ◽

Late Preterm Infants ◽

The Mean

Background: Late preterm infants suffer from several problems after birth, and the key factor in fighting these problems is effective breastfeeding. Objective: To determine breastfeeding self-efficacy and its relationship with perceived stress and assess breastfeeding performance in mothers with late preterm infants Methods: In this prospective study, 171 eligible nursing mothers with late preterm infants born in Alzahra Medical Center of Tabriz, Iran, were selected via convenience sampling. The Breastfeeding Self-Efficacy Scale-Short Form was employed to measure breastfeeding self-efficacy, and the 14-item Perceived Stress Scale was used to measure the perceived stress 24 hours after giving birth. When the child was 4 months old, breastfeeding performance was measured by the Standard Breastfeeding Performance Questionnaire. The data were analyzed by Pearson and Spearman’s correlation tests, independent t-test, one-way ANOVA, and multiple linear regression analysis. Results: The mean (standard deviation) of breastfeeding self-efficacy was 50.0 (7.8) with scores ranging from 13 to 65, and the mean (standard deviation) of perceived stress was 26.5 (8.8) with scores ranging from 0 to 56. The median (25-75 percentiles) of breastfeeding performance score equaled 2.0 (1.0 to 3.0) with scores ranging from 0 to 6. Based on multiple linear regression analysis and after adjusting the personal-social characteristics, by increasing the score of breastfeeding self-efficacy, perceived stress was significantly decreased (B=-0.1, 95%CI=-0.3 to 0.0). However, there was no statistically significant relationship between breastfeeding self-efficacy and breastfeeding performance (p=0.418). Conclusion: Due to the possibility of adjusting breastfeeding self-efficacy and its role in mothers’ perceived stress, developing proper strategies seems to be essential for enhancing breastfeeding self-efficacy.

Download Full-text