Development of neonatal high-risk preterm infants in comparison to full-term counterparts

2021 ◽  
pp. 1-10
Author(s):  
Juliana Cunha de Lima Rodrigues ◽  
Cláudia Maria Gaspardo ◽  
Maria Beatriz Martins Linhares
Keyword(s):  
High Risk ◽  
Preterm Infants ◽  
Full Term

scholarly journals Influencing factors of the neurodevelopment of high-risk infants

2018 ◽  
Vol 31 (3) ◽  
pp. e100034 ◽  
Author(s):  
Yuan Tian ◽  
Chuncao Zhang ◽  
Guangjun Yu ◽  
Xiangying Hu ◽  
Zheng Pu ◽  
...  
Keyword(s):  
High Risk ◽  
Influencing Factors ◽  
Preterm Infants ◽  
Infant Health ◽  
Vital Role ◽  
Postnatal Period ◽  
Full Term ◽  
Developmental Abnormalities ◽  
Neurodevelopmental Abnormalities ◽  
High Risk Infants

BackgroundHigh-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of developmental abnormalities plays a vital role in improving high-risk infants’ quality of life.AimsTo describe the neurodevelopment of high-risk infants aged less than 1 year old, and to analyse the incidences and influencing factors of neurodevelopmental abnormalities in order to provide a basis for neurodevelopment monitoring and management of high-risk infants.MethodsHigh-risk infants born between January 2016 and December 2016 in the maternity and infant health hospitals of three districts in Shanghai were followed up. The Gesell Developmental Scale was used to assess the neurodevelopmental level at the time of recruitment (0–2 months) and at 9 months. Univariate and multivariate analyses of the influencing factors were conducted.Results484 high-risk infants (male 51%, female 49%) with an average gestation age of 36.5±2.2 weeks were recruited. At the time of recruitment, the average age was 2.1 (0.8) months, and the developmental quotient (DQ) scores of full-term high-risk infants in motor (t=3.542,p=0.001), cognitive (t=3.125,p=0.002), language (t=3.189,p=0.002) and social (t=3.316,p=0.001) areas were higher than those of preterm infants. The incidences of developmental abnormalities of full-term high-risk infants in motor (χ2=9.452,p=0.002), cognitive (χ2=6.258,p=0.012), language (χ2=12.319,p=0.001) and social (χ2=6.811,p=0.009) areas were lower than the preterm infants. At 9 months, there was no difference in the DQ scores and incidences of developmental abnormalities in four areas between full-term and preterm high-risk infants, and the incidence of developmental abnormalities was around 10%.ConclusionThe incidence of neurodevelopmental abnormalities in high-risk infants aged less than 1 year old is high. Preterm birth and parental bad habits are significant factors affecting the neurodevelopment. Monitoring and early interventions help to improve high-risk infants’ neurodevelopment.

scholarly journals Increasing urinary podocyte mRNA excretion and progressive podocyte loss in kidney contribute to the high risk of long-term renal disease caused by preterm birth

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fangrui Ding ◽  
Qi Gao ◽  
Xiuying Tian ◽  
Jiali Mo ◽  
Jun Zheng
Keyword(s):  
High Risk ◽  
Renal Disease ◽  
Preterm Infants ◽  
Excretion Rate ◽  
Full Term ◽  
Urine Samples ◽  
Mrna Levels ◽  
Term Infants ◽  
Podocyte Loss

AbstractPodocyte abnormalities are common mechanism driving the progression of glomerular diseases, which account for most chronic kidney diseases (CKDs). However, the role of podocyte in the mechanism of high-risk long-term CKD caused by prematurity has not been well clarified. In present study, urine samples of 86 preterm infants and 32 full-term infants were collected, and podocyte-specific podocin mRNA levels in urine pellet were applied to indicate urinary podocyte mRNA excretion. In addition, in a preterm animal rat model, preterm rats were identified by delivery 2 days early. From the age of 3 weeks–12 months, urine samples were collected to examine podocyte mRNA excretion by measuring podocyte-specific podocin mRNA levels. Kidney samples at the age of 3 weeks, 2 months, and 12 months were collected from 8, 5 and 6 preterm rats and 9, 6 and 8 full-term rats, respectively, to examine podocyte density and podocyte area by measuring the podocyte specific nuclear marker WT-1 and the podocyte specific marker synaptopodin. As results, a more than threefold increase of urinary podocyte-specific podocin mRNA excretion rate was found in preterm infants compared with full-term infants. In addition, there was negative correlation between gestational age at birth and urinary podocin mRNA excretion. In preterm rats, a reduction in the total number of differentiated podocytes in glomeruli and an increased podocyte podocin mRNA excretion rate in urine were detected at the end of kidney differentiation. Moreover, long-term follow-up data in preterm rats showed there was an increased the risk of renal disease indicated by persistent podocyte mRNA loss, proteinuria, and enlarged glomeruli. In conclusion, increasing podocyte mRNA excretion in urine and podocyte loss in kidney led by prematurity drive the progression of long-term abnormal kidney function and could potentially explain the high risk of long-term CKD in preterm infants.

Infant–Father Attachment in Infants Born Preterm - A Brief Report

2021 ◽  
pp. 1-6
Author(s):  
Ruediger Kissgen ◽  
Sebastian Franke ◽  
Nino Jorjadze ◽  
Bernhard Roth ◽  
Angela Kribs
Keyword(s):  
Preterm Infants ◽  
Full Term ◽  
Strange Situation ◽  
Term Infants ◽  
Attachment Quality ◽  
Attachment Research ◽  
Neurodevelopmental Problems ◽  
Strange Situation Procedure ◽  
Father Attachment

This study examines the infant–father attachment in infants born preterm (<  1500 g at birth and/or <  37 weeks gestation) in comparison to full-term infants. The infant–father attachment was assessed using the Strange Situation Procedure at a (corrected) age of 15 months. We found at least half of preterm and full-term infants (50.0% and 56.5 % respectively) securely attached to their fathers, and no significant overall difference was observed concerning the distribution of attachment quality comparing the two groups. In light of the fact that preterm infants tend to have numerous neurodevelopmental problems, it is encouraging that significant differences were not found in the distribution of the attachment quality among the groups. Therefore, from the perspective of attachment research, it would be highly beneficial to include fathers in the care of their preterm infants.

Evaluation of Airway Complications in High-Risk Preterm Infants: Application of Flexible Fiberoptic Airway Endoscopy

PEDIATRICS ◽  
1995 ◽  
Vol 95 (4) ◽  
pp. 567-572
Author(s):  
Gregory J. Downing ◽  
Howard W. Kilbride
Keyword(s):  
High Risk ◽  
Preterm Infants ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Subglottic Stenosis ◽  
High Risk Population ◽  
Risk Population ◽  
Airway Complications ◽  
Airway Injury ◽  
Airway Abnormalities

Objectives. We sought to determine factors that would predict the development of subglottic stenosis (SGS) and tracheomalacia (TM) in preterm infants. The utility of a semiquantitative measurement of airway dimensions was assessed in relation to signs of airway complications. We also sought to determine from a high-risk population of infants those likely to have abnormal findings identified by bronchoscopic examination. Methods. Prospective airway endoscopy was performed for preterm infants who were intubated for 7 days or more or who demonstrated chronic oxygen needs beyond 28 days after birth and 36 weeks postconceptional age. Subjects were 117 preterm (less than 36 weeks' gestation) infants from two level III intensive care nurseries. Endoscopy was used to classify the type and degree of airway injury. Subglottic stenosis was defined subjectively and compared with an objective measurement using subglottic spatial relations described as a trans- subglottic/vocal cord ratio (TSG/VC). Clinical signs and symptoms and other risk factors were evaluated as significant predictors of SGS and TM, identified by bronchoscopy. Results. Moderate or severe airway abnormalities were identified in 32 patients (27.3%); 13 with SGS, 17 with TM, and 2 with both. All but one infant with TSG/VC less than 0.83 had signs and symptoms of airway dysfunction. Variables more commonly found in patients with SGS included greater number of intubations, use of inappropriately large endotracheal tubes, and longer duration of intubation. Higher averaged mean airway pressure during the first week after birth and lower gestational age were clinical features associated with TM. Conclusions. Flexible bronchoscopic evaluation of a high-risk population demonstrated a higher incidence of moderate or severe SGS or TM than previously suspected. Subglottic stenosis and TM appear to have different etiologies based on different factors associated with their development. The TSG/VC ratio correlated well with obstructive symptoms and may represent a means to quantitate clinically subglottic narrowing. Infants with chronic lung disease who have persistently elevated partial pressure of carbon dioxide, apnea, or phonation abnormalities are most likely to have airway abnormalities identifiable by bronchoscopy.

Reduction in Obstructive Breathing Events During Body Rocking: A Controlled Polygraphic Study in Preterm and Full-Term Infants

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 64-68
Author(s):  
J. Groswasser ◽  
M. Sottiaux ◽  
E. Rebuffat ◽  
T. Simon ◽  
M. Vandeweyer ◽  
...  
Keyword(s):  
Eye Movement ◽  
Preterm Infants ◽  
Upper Airway ◽  
Periodic Breathing ◽  
Full Term ◽  
Rapid Eye Movement ◽  
Term Infants ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Obstructive Sleep Apneas

Objective. To investigate the effect of body rocking on infant respiratory behavior during sleep. Methods. Eighteen infants with documented obstructive sleep apneas were studied. There were eight premature infants with persistent bradycardias and 10 infants born full-term, admitted after an idiopathic apparent life-threatening event. No cause for the obstructive apneas was found. The infants were recorded with polygraphic techniques during two successive nights. They were randomly assigned to a rocking or a nonrocking mattress. The conditions were reversed the following night, in a crossover design. Results. In both groups of infants, no significant difference was seen between the two consecutive nights for most of the variables studied: total sleep time, the proportion of non-rapid-eye-movement and rapid-eye-movement sleep, the number of arousals, the number and maximal duration of central apneas, the frequency of periodic breathing, the level of oxygen saturation, and heart rate. During the nonrocking nights, all infants had repeated obstructive breathing events. In seven of the eight preterm infants and in nine of the 10 full-term subjects, body rocking was associated with a significant decrease in the frequency of obstructive events. During rocking, in the preterm infants the obstructions fell from a median of 2.5 to 1.8 episodes per hour (P = .034). In the full-term infants, rocking reduced the obstructive events from a median of 1.5 obstructions per hour to 0.7 (P = .005). No difference was seen for the duration of the obstructive episodes. Conclusion. In preterm and full-term infants prone to obstructive sleep apneas, gentle side-to-side body rocking is associated with a significant decrease in the frequency of upper-airway obstructions.

Vaccinations in Infants Born Preterm: An Update

2020 ◽  
Vol 16 (2) ◽  
pp. 148-155
Author(s):  
Areti Aphrodite Sioriki ◽  
Despoina Gkentzi ◽  
Evangelia Papadimitriou ◽  
Gabriel Dimitriou ◽  
Ageliki Karatza
Keyword(s):  
Preterm Infants ◽  
Vaccine Safety ◽  
Full Term ◽  
Morbidity And Mortality ◽  
Term Infants ◽  
Safety And Efficacy ◽  
Vaccine Preventable Diseases ◽  
Increased Risk ◽  
Protective Antibodies

Infants born prematurely (before completion of 37 weeks of gestation) are at increased risk of morbidity and mortality due to vaccine preventable diseases, mostly because of their immunological immaturity and failure of transfer of maternal protective antibodies. Despite their great need of being vaccinated, concerns on vaccine safety and efficacy, constitute the main reasons for which vaccinations are often delayed in this group. In this review we summarize the latest evidence on vaccine safety, efficacy and immunogenicity in preterm infants which is similar to full-term infants. Therefore there is no reason for delaying vaccination in this population.

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