scholarly journals Low‐grade intraventricular haemorrhage is not as harmless as first thought when born extremely preterm

2021 ◽  
Author(s):  
Ranveer Sanghera ◽  
Jonathan Cusack
Keyword(s):  
Intraventricular Haemorrhage ◽  
Low Grade ◽  
Extremely Preterm

scholarly journals School-age outcomes following intraventricular haemorrhage in infants born extremely preterm

2020 ◽  
Vol 106 (1) ◽  
pp. 4-8 ◽  
Author(s):  
Nicky Laura Hollebrandse ◽  
Alicia J Spittle ◽  
Alice C Burnett ◽  
Peter J Anderson ◽  
Gehan Roberts ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Executive Function ◽  
Motor Function ◽  
Intraventricular Haemorrhage ◽  
Academic Skills ◽  
Intellectual Ability ◽  
Low Grade ◽  
Cranial Ultrasound ◽  
Neurodevelopmental Outcomes ◽  
Extremely Preterm

ObjectiveTo determine the associations of different grades of intraventricular haemorrhage (IVH), particularly grades 1 and 2, with neurodevelopmental outcomes at 8 years of age in children born extremely preterm.DesignPopulation-based cohort study.SettingState of Victoria, Australia.PatientsSurvivors born at <28 weeks’ gestational age (n=546) and matched term-born controls (n=679) from three distinct eras, namely, those born in 1991–1992, 1997 and 2005.ExposureWorst grade of IVH detected on serial neonatal cranial ultrasound.Outcome measuresIntellectual ability, executive function, academic skills, cerebral palsy and motor function at 8 years.ResultsThere was a trend for increased motor dysfunction with increasing severity of all grades of IVH, from 24% with no IVH, rising to 92% with grade 4 IVH. Children with grade 1 or 2 IVH were at higher risk of developing cerebral palsy than those without IVH (OR 2.24, 95% CI 1.21 to 4.16). Increased rates of impairment in intellectual ability and academic skills were observed with higher grades of IVH, but not for grade 1 and 2 IVH. Parent-rated executive functioning was not related to IVH.ConclusionWhile low-grade IVH is generally considered benign, it was associated with higher rates of cerebral palsy in school-aged children born EP, but not with intellectual ability, executive function, academic skills or overall motor function. Higher grades of IVH were associated with higher rates and risks of impairment in motor function, intellectual ability and some academic skills, but not parental ratings of executive function.

EEG - A Valuable Biomarker of Brain Injury in Preterm Infants

2017 ◽  
Vol 39 (1-4) ◽  
pp. 23-35 ◽  
Author(s):  
Elena Pavlidis ◽  
Rhodri O. Lloyd ◽  
Geraldine B. Boylan
Keyword(s):  
Preterm Infants ◽  
Brain Injuries ◽  
Perinatal Asphyxia ◽  
Periventricular Leukomalacia ◽  
Intraventricular Haemorrhage ◽  
Sharp Waves ◽  
Developmental Neuroscience ◽  
Extremely Preterm

This review focuses on the role of electroencephalography (EEG) in monitoring abnormalities of preterm brain function. EEG features of the most common developmental brain injuries in preterm infants, including intraventricular haemorrhage, periventricular leukomalacia, and perinatal asphyxia, are described. We outline the most common EEG biomarkers associated with these injuries, namely seizures, positive rolandic sharp waves, EEG suppression/increased interburst intervals, mechanical delta brush activity, and other deformed EEG waveforms, asymmetries, and asynchronies. The increasing survival rate of preterm infants, in particular those that are very and extremely preterm, has led to a growing demand for a specific and shared characterization of the patterns related to adverse outcome in this unique population. This review includes abundant high-quality images of the EEG patterns seen in premature infants and will provide a valuable resource for everyone working in developmental neuroscience.

Superior vena cava flow and intraventricular haemorrhage in extremely preterm infants

2015 ◽  
Vol 29 (10) ◽  
pp. 1581-1587 ◽  
Author(s):  
Sarah Bates ◽  
David Odd ◽  
Karen Luyt ◽  
Paul Mannix ◽  
Richard Wach ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Intraventricular Haemorrhage ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Outcomes of outborn extremely preterm neonates admitted to a NICU with respiratory distress

2019 ◽  
Vol 105 (1) ◽  
pp. 33-40 ◽  
Author(s):  
Jennifer L Fang ◽  
Kristin C Mara ◽  
Amy L Weaver ◽  
Reese H Clark ◽  
William A Carey
Keyword(s):  
Propensity Score ◽  
Neonatal Intensive Care ◽  
Proportional Hazards ◽  
Intraventricular Haemorrhage ◽  
Cox Proportional Hazards ◽  
Preterm Neonates ◽  
Mortality And Morbidity ◽  
Risk Of Mortality ◽  
Extremely Preterm ◽  
The Usa

ObjectiveTo compare the risk of mortality and morbidity between outborn and propensity score-matched inborn extremely preterm neonates.SettingMultiple neonatal intensive care units (NICU) across the USA.PatientsSingleton neonates born at 22–29 weeks’ gestation with no major anomalies who were admitted to a NICU and discharged between 2000 and 2014. Outborn neonates were restricted to those who transferred into a NICU on the day of birth.MethodsThe association between inborn-outborn status and the time-to-event outcomes of in-hospital mortality and necrotising enterocolitis (NEC) were assessed using Cox proportional hazards regression. Logistic regression was used to assess the remaining secondary outcomes: retinopathy of prematurity requiring treatment (tROP), chronic lung disease (CLD), periventricular leucomalacia (PVL) and severe intraventricular haemorrhage (IVH). Since outborn status was not random, we used 1:1 propensity score matching to reduce the imbalance in illness severity.ResultsThere were 59 942 neonates (7991 outborn) included in the study. Outborn neonates had poorer survival than inborns and higher rates of NEC, severe IVH, tROP and PVL. Inborn-outborn disparities in mortality were reduced over the study period. When analysing the matched cohort (6524 matched pairs), outborns were less likely to die in-hospital compared with inborns (HR 0.84, 95% CI 0.77 to 0.91). However, outborns experienced higher rates of NEC (HR 1.14, 95% CI 1.04 to 1.25), severe IVH (OR 1.52, 95% CI 1.38 to 1.68), tROP (OR 1.45, 95% CI 1.25 to 1.69) and CLD (OR 1.12, 95% CI 1.01 to 1.24).ConclusionAdditional research is needed to understand the contributors to increased morbidity for outborn extremely preterm neonates and identify interventions that mitigate this risk.

Neonatal outcomes of extremely preterm twins by sex pairing: an international cohort study

2020 ◽  
Vol 106 (1) ◽  
pp. 17-24
Author(s):  
Luigi Gagliardi ◽  
Franca Rusconi ◽  
Brian Reichman ◽  
Mark Adams ◽  
Neena Modi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Reference Group ◽  
Periventricular Leukomalacia ◽  
Intraventricular Haemorrhage ◽  
Neonatal Outcomes ◽  
Composite Outcome ◽  
Lower Odds ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Opposite Sex

ObjectiveInfant boys have worse outcomes than girls. In twins, the ‘male disadvantage’ has been reported to extend to female co-twins via a ‘masculinising’ effect. We studied the association between sex pairing and neonatal outcomes in extremely preterm twins.DesignRetrospective cohort studySettingEleven countries participating in the International Network for Evaluating Outcomes of Neonates.PatientsLiveborn twins admitted at 23–29 weeks’ gestation in 2007–2015.Main outcome measuresWe examined in-hospital mortality, grades 3/4 intraventricular haemorrhage or cystic periventricular leukomalacia (IVH/PVL), bronchopulmonary dysplasia (BPD), retinopathy of prematurity requiring treatment and a composite outcome (mortality or any of the outcomes above).ResultsAmong 20 924 twins, 38% were from male-male pairs, 32% were from female-female pairs and 30% were sex discordant. We had no information on chorionicity. Girls with a male co-twin had lower odds of mortality, IVH/PVL and the composite outcome than girl-girl pairs (reference group): adjusted OR (aOR) (95% CI) 0.79 (0.68 to 0.92), 0.83 (0.72 to 0.96) and 0.88 (0.79 to 0.98), respectively. Boys with a female co-twin also had lower odds of mortality: aOR 0.86 (0.74 to 0.99). Boys from male-male pairs had highest odds of BPD and composite outcome: aOR 1.38 (1.24 to 1.52) and 1.27 (1.16 to 1.39), respectively.ConclusionsSex-related disparities in outcomes exist in extremely preterm twins, with girls having lower risks than boys and opposite-sex pairs having lower risks than same-sex pairs. Our results may help clinicians in assessing risk in this large segment of extremely preterm infants.

scholarly journals Burden of hypoxia and intraventricular haemorrhage in extremely preterm infants

2019 ◽  
Vol 105 (3) ◽  
pp. 242-247 ◽  
Author(s):  
Isabel Hui Xuan Ng ◽  
Cristine Sortica da Costa ◽  
Fred A Zeiler ◽  
Flora Y Wong ◽  
Peter Smielewski ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Near Infrared ◽  
Oxygenation Index ◽  
Intraventricular Haemorrhage ◽  
Cerebral Hypoxia ◽  
Mean Values ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Tissue Oxygenation Index ◽  
The Relationship

ObjectiveThresholds of cerebral hypoxia through monitoring of near-infrared spectroscopy tissue oxygenation index (TOI) were used to investigate the relationship between intraventricular haemorrhage (IVH) and indices of hypoxia.DesignProspective observational study.SettingA single-centre neonatal intensive care unit.PatientsInfants <28 weeks’ gestation with an umbilical artery catheter.MethodsThresholds of hypoxia were determined from mean values of TOI using sequential Χ2 tests and used alongside thresholds from existing literature to calculate percentage of time in hypoxia and burden of hypoxia below each threshold. These indices were then compared between IVH groups.Results44 infants were studied for a median of 18.5 (range 6–21) hours in the first 24 hours of life. Sequential Χ2 analysis yielded a TOI threshold of 71% to differentiate between IVH (16 infants) and no IVH (28 infants). Percentage of time in hypoxia was significantly higher in infants with IVH than those without, using thresholds of 60%–67%. Burden of hypoxia was significantly higher in infants with IVH than without, using thresholds of 62%–80%. With the threshold of 71%, percentage of time in hypoxia was lower by 12.2% with a 95% CI of (−25.7 to 1.2) (p=0.073), and the burden of hypoxia was lower by 29.2% hour (%h) (95% CI −55.2 to −3.1)%h (p=0.012) in infants without IVH than those with IVH.ConclusionsUsing defined TOI thresholds, infants with IVH spent higher percentage of time in hypoxia with higher burden of cerebral hypoxia than those without, in the first 24 hours of life.

Method of delivery and intraventricular haemorrhage in extremely preterm infants

2010 ◽  
Vol 23 (12) ◽  
pp. 1419-1423 ◽  
Author(s):  
Carlo Dani ◽  
Chiara Poggi ◽  
Giovanna Bertini ◽  
Simone Pratesi ◽  
Mariarosaria Di Tommaso ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Intraventricular Haemorrhage ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Direct Observation of Crystalline Ordering In Naturally Graphitized Carbon Produced by Low Grade Metamorphism

1977 ◽  
Vol 35 ◽  
pp. 162-163
Author(s):  
Thomas R. McKee ◽  
Peter R. Buseck
Keyword(s):  
Crystallite Size ◽  
Sedimentary Rocks ◽  
Carbonaceous Material ◽  
Low Grade ◽  
X Ray ◽  
Graphitized Carbon ◽  
Transmission Electron ◽  
Heat Treated ◽  
Commercial Carbon ◽  
Metamorphic Zone

Sediments commonly contain organic material which appears as refractory carbonaceous material in metamorphosed sedimentary rocks. Grew and others have shown that relative carbon content, crystallite size, X-ray crystallinity and development of well-ordered graphite crystal structure of the carbonaceous material increases with increasing metamorphic grade. The graphitization process is irreversible and appears to be continous from the amorphous to the completely graphitized stage. The most dramatic chemical and crystallographic changes take place within the chlorite metamorphic zone.The detailed X-ray investigation of crystallite size and crystalline ordering is complex and can best be investigated by other means such as high resolution transmission electron microscopy (HRTEM). The natural graphitization series is similar to that for heat-treated commercial carbon blacks, which have been successfully studied by HRTEM (Ban and others).

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