Voice problems in school-aged children following very preterm birth

Background and objectiveVery preterm children may be at risk of voice abnormalities (dysphonia). Risk factors previously identified in extremely preterm children include female gender, multiple intubations, complicated intubation and very low birth weight. This study sought to identify the prevalence of dysphonia in very preterm children, at school age.MethodsChildren born between 23 and 32 weeks’ gestation were included in this prospective observational study. Participants were randomly selected from a sample stratified by gestational age and number of intubations, and were aged between 5 and 12 years at the time of assessment. Clinical voice assessments were conducted by a speech pathologist, and a diagnosis of dysphonia was made based on the presence and severity of disturbance to the voice. Retrospective chart review identified medical and demographic characteristics.Results178 participants were assessed. The prevalence of dysphonia in this cohort was 61%. 31% presenting with significant dysphonia, that is, voice disturbance of greater than mild in severity. Female gender (p=0.009), gestational age (p=0.031) and duration of intubation (p=0.021) were significantly associated with dysphonia although some preterm children with dysphonia were never intubated.ConclusionsSignificant voice abnormalities were observed in children born at up to 32 weeks’ gestation, with intubation a major contributing factor.Trial registration numberACTRN12613001015730.

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Prevalence of Language Delay among Healthy Preterm Children, Language Outcomes and Predictive Factors

Children ◽

10.3390/children8040282 ◽

2021 ◽

Vol 8 (4) ◽

pp. 282

Author(s):

Miguel Pérez-Pereira

Keyword(s):

Gestational Age ◽

Language Impairment ◽

Maternal Education ◽

Longitudinal Design ◽

Age Groups ◽

Full Term ◽

Language Delay ◽

Preterm Children ◽

General Terms ◽

Extremely Preterm

Language delay (LD) and its relationship with later language impairment in preterm children is a topic of major concern. Previous studies comparing LD in preterm (PT) and full-term (FT) children were mainly carried out with samples of extremely preterm and very preterm children (sometimes with additional medical problems). Very few of them were longitudinal studies, which is essential to understand developmental relationships between LD and later language impairment. In this study, we compare the prevalence of LD in low-risk preterm children to that of FT children in a longitudinal design ranging from 10 to 60 months of age. We also analyze which variables are related to a higher risk of LD at 22, 30 and 60 months of age. Different language tests were administered to three groups of preterm children of different gestational ages and to one group of full-term children from the ages of 10 to 60 months. ANOVA comparisons between groups and logistic regression analyses to identify possible predictors of language delay at 22, 30 and 60 months of age were performed. The results found indicate that there were practically no differences between gestational age groups. Healthy PT children, therefore, do not have, in general terms, a higher risk of language delay than FT children. Previous language delay and cognitive delay are the strongest and longest-lasting predictors of later language impairment. Other factors, such as a scarce use of gestures at 10 months or male gender, affect early LD at 22 months of age, although their effect disappears as children grow older. Low maternal education appears to have a late effect. Gestational age does not have any significant effect on the appearance of LD.

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Gestational Age Dependency of Umbilical Cord Serum IL-6 Levels for Detecting Fetal Inflammation

American Journal of Perinatology ◽

10.1055/s-0040-1721373 ◽

2020 ◽

Author(s):

Sota Iwatani ◽

Takao Kobayashi ◽

Sachiko Matsui ◽

Akihiro Hirata ◽

Miwa Yamamoto ◽

...

Keyword(s):

Umbilical Cord ◽

Gestational Age ◽

Area Under The Curve ◽

Roc Curves ◽

Significant Negative Correlation ◽

Cord Serum ◽

Very Preterm ◽

Key Points ◽

Extremely Preterm ◽

Preterm Newborns

Objective The fetal inflammatory response syndrome (FIRS) is characterized by elevated concentrations of inflammatory cytokines in fetal blood, with preterm delivery and morbidity. Umbilical cord serum interleukin-6 (UC-s-IL-6) is an ideal marker for detecting FIRS. However, the effect of gestational age (GA) on UC-s-IL-6 levels has not been reported. This study aimed to determine the relationship between GA and UC-s-IL-6 levels, and GA-dependent cutoff values of UC-s-IL-6 levels for detecting fetal inflammation. Study Design UC-s-IL-6 concentrations were measured in 194 newborns (44 extremely preterm newborns (EPNs) at 22–27 weeks' GA, 68 very preterm newborns (VPNs) at 28–31 weeks' GA, and 82 preterm newborns (PNs) at 32–34 weeks' GA). Linear regression analyses were used to correlate GA and UC-s-IL-6 levels. Receiver operating characteristic (ROC) curves analyses were performed for detecting the presence of funisitis, as the histopathological counterpart of FIRS. Results A significant negative correlation between GA and UC-s-IL-6 levels was found in newborns with severe funisitis (r s = − 0.427, p = 0.004) and those with mild funisitis (r s = − 0.396, p = 0.025). ROC curve analyses revealed the area under the curve for detecting funisitis were 0.856, 0.837, and 0.622 in EPNs, VPNs, and PNs, respectively. The UC-s-IL-6 cutoff value in EPNs (28.1 pg/mL) exceeded those in VPNs and PNs (3.7 and 3.0 pg/mL, respectively). Conclusion UC-s-IL-6 levels were inversely correlated with GA especially in newborns with funisitis. Such GA dependency of UC-s-IL-6 should be considered for detecting fetal inflammation. Key Points

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Strabismus in very low birth weight and/or very preterm children: Discrepancy between age of onset and start of treatment

European Journal of Pediatrics ◽

10.1007/bf01954277 ◽

1995 ◽

Vol 154 (3) ◽

pp. 225-229 ◽

Cited By ~ 7

Author(s):

J. W. R. Pott ◽

J. Van Hof-van Duin ◽

I. J. Heersema ◽

W. P. F. Fetter ◽

A. M. Schreuder ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Age Of Onset ◽

Preterm Children ◽

Very Preterm

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Do emissions from landfill fires affect pregnancy outcomes? A retrospective study after arson at a solid waste facility in Sicily

BMJ Open ◽

10.1136/bmjopen-2018-027912 ◽

2019 ◽

Vol 9 (7) ◽

pp. e027912 ◽

Cited By ~ 2

Author(s):

Walter Mazzucco ◽

Elisa Tavormina ◽

Maurizio Macaluso ◽

Claudia Marotta ◽

Rosanna Cusimano ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Maternal Age ◽

Very Low Birth Weight ◽

Reference Group ◽

Study Group ◽

Live Births ◽

Very Preterm ◽

Infant Gender

ObjectivesIn response to public health concern about effects of arson at solid waste management plants in July 2012, we analysed vital statistics data to evaluate any potential effect on pregnancies at different gestational ages of pollutants emitted from the landfill on fire.SettingA community living near the largest landfill plant in Sicily.ParticipantsThe study group comprised 551 births, live births and stillbirths from pregnancies of mothers residing in the extra-urban exposed area, conceived during a 40 week period during which the highest fire’s peak might have influenced pregnancy.Primary and secondary outcome measuresBirth outcomes (gestational age <37 and <32 weeks, low birth weight, very low birth weight and small for gestational age) in the study group were compared with the ones of a reference group of women residing in areas of Sicily with similarly low population density and industrial development.ResultsAmong singleton live births we observed a three-fold increase in risk of very preterm birth between the extra-urban area and the remaining low inhabitants density and unindustrialised areas for births whose pregnancies were in the third trimester (OR adjusted for maternal age and infant gender=3.41; 95% CI 1.04 to 11.16). There was an excess of very low birth weight singleton infants in the study group as compared with the reference group, which was limited to births to mothers exposed during periconception period (OR adjusted for maternal age and infant gender=4.64; 95% CI 1.04 to 20.6) and first trimester (OR adjusted for maternal age and infant gender=3.66; 95% CI 1.11 to 12.1). The association estimates were imprecise due to the small number of outcomes recorded.ConclusionsThe study documented an excess of very preterm and very low birth weight among infants born to mothers exposed to the landfill fire emissions during conception or early pregnancy.

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Prevalence and Longevity of PTSD Symptoms Among Parents of NICU Infants Analyzed Across Gestational Age Categories

Clinical Pediatrics ◽

10.1177/0009922819892046 ◽

2019 ◽

Vol 59 (2) ◽

pp. 163-169 ◽

Cited By ~ 3

Author(s):

Rachel Schecter ◽

Tammy Pham ◽

Alexandra Hua ◽

Regina Spinazzola ◽

Jill Sonnenklar ◽

...

Keyword(s):

Gestational Age ◽

Neonatal Intensive Care ◽

Counseling Services ◽

Ptsd Symptoms ◽

Exact Test ◽

Very Preterm ◽

High Severity ◽

Extremely Preterm ◽

P 16

Objective. This study aims to investigate whether posttraumatic stress disorder (PTSD) symptoms exist >1 year after neonatal intensive care unit (NICU) experience and whether PTSD symptomatology differs across parents of infants of different gestational age categories. Methods. A survey was given to parents at routine NICU follow-up visits. Parents completed the PTSD CheckList–Civilian (PCL-C), a standardized scale comprising 17 key symptoms of PTSD. Parents also rated how traumatic their birth experience, first day in the NICU, and first week in the NICU were from “Not Traumatic at All” to “Most Traumatic.” Fisher’s exact test was used to compare PCL-C responses across gestational age categories (Extremely Preterm, Very Preterm, Moderate to Late preterm, and Full Term). Results. Eighty parents participated. In total, 15% of parents had “Moderate to High Severity” PTSD symptoms. There were no statistical differences in PTSD prevalence between parents of children <1 year old and parents of children >1 year old ( P = .51). There was also no statistical difference in prevalence of “Moderate to High Severity” level of PTSD symptoms across gestational age ( P = .16). Overall, 38% of parents rated at least one experience as “Most traumatic.” Conclusion. A high percentage of parents who had a recent NICU experience and parents who had a NICU experience more than a year ago demonstrated PTSD symptoms. In light of these results, many parents of NICU graduates—both mothers and fathers—would benefit from access to long-term counseling services.

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Craniofacial Morphology in Prematurely Born Children

The Angle Orthodontist ◽

10.2319/030108-124.1 ◽

2009 ◽

Vol 79 (2) ◽

pp. 276-283 ◽

Cited By ~ 12

Author(s):

Liselotte Paulsson ◽

Lars Bondemark

Keyword(s):

Head Circumference ◽

Null Hypothesis ◽

Full Term ◽

Craniofacial Morphology ◽

Control Group ◽

Preterm Children ◽

Very Preterm ◽

Anterior Cranial Base ◽

Extremely Preterm ◽

Preterm Group

Abstract Objective: To test the null hypothesis that there is no difference between the craniofacial morphology of prematurely born children and that of matched full-term born controls. Materials and Methods: White children 8 to 10 years of age, born at the University Hospitals of Lund and Malmö and living in the same part of Sweden, were included. One group consisted of 36 very preterm children, born during gestational weeks 29 to 32; the other group included 36 extremely preterm children, who were born before the 29th gestational week. Subjects were compared with a control group of 31 full-term children, who were matched for gender, age, nationality, and living area. One lateral head radiograph was taken for each child, and the cephalometric analysis included 15 angular and 11 linear variables. Also, the height, weight, and head circumference of each child were registered. Results: A significantly shorter anterior cranial base and a less convex skeletal profile were found among extremely preterm children, and significantly shorter maxillary length was noted in both extremely preterm and very preterm groups as compared with full-term children. The lower incisors were significantly more retroclined and retruded in the extremely preterm group compared with the very preterm group and the full-term control group. Extremely preterm children were significantly shorter, and both extremely preterm and very preterm children had significantly lower weight and smaller head circumference compared with full-term children. Conclusion: The null hypothesis was rejected because several craniofacial parameters differed significantly between preterm and full-term born control children.

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Multiparametric Analysis of Cerebral Development in Preterm Infants Using Magnetic Resonance Imaging

Frontiers in Neuroscience ◽

10.3389/fnins.2021.658002 ◽

2021 ◽

Vol 15 ◽

Author(s):

Marine Dubois ◽

Antoine Legouhy ◽

Isabelle Corouge ◽

Olivier Commowick ◽

Baptiste Morel ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Preterm Infants ◽

Gestational Age ◽

Brain Maturation ◽

Resonance Imaging ◽

Equivalent Age ◽

Very Preterm ◽

Extremely Preterm ◽

The Impact

ObjectivesThe severity of neurocognitive impairment increases with prematurity. However, its mechanisms remain poorly understood. Our aim was firstly to identify multiparametric magnetic resonance imaging (MRI) markers that differ according to the degree of prematurity, and secondly to evaluate the impact of clinical complications on these markers.Materials and MethodsWe prospectively enrolled preterm infants who were divided into two groups according to their degree of prematurity: extremely preterm (<28 weeks’ gestational age) and very preterm (28–32 weeks’ gestational age). They underwent a multiparametric brain MRI scan at term-equivalent age including morphological, diffusion tensor and arterial spin labeling (ASL) perfusion sequences. We quantified overall and regional volumes, diffusion parameters, and cerebral blood flow (CBF). We then compared the parameters for the two groups. We also assessed the effects of clinical data and potential MRI morphological abnormalities on those parameters.ResultsThirty-four preterm infants were included. Extremely preterm infants (n = 13) had significantly higher frontal relative volumes (p = 0.04), frontal GM relative volumes (p = 0.03), and regional CBF than very preterm infants, but they had lower brainstem and insular relative volumes (respectively p = 0.008 and 0.04). Preterm infants with WM lesions on MRI had significantly lower overall GM CBF (13.3 ± 2 ml/100 g/min versus 17.7 ± 2.5, < ml/100 g/min p = 0.03).ConclusionMagnetic resonance imaging brain scans performed at term-equivalent age in preterm infants provide quantitative imaging parameters that differ with respect to the degree of prematurity, related to brain maturation.

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Strabismus in very low birth weight and/or very preterm children: discrepancy between age of onset and start of treatment

European Journal of Pediatrics ◽

10.1007/s004310050281 ◽

1995 ◽

Vol 154 (3) ◽

pp. 225-229

Author(s):

J. W. R. Pott ◽

J. Van Hof-van Duin ◽

D. J. Heersema ◽

W. P. F. Fetter ◽

A. M. Schreuder ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Age Of Onset ◽

Preterm Children ◽

Very Preterm

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COMPARISON OF SERUM CALCIUM LEVELS AMONG EXTREMELY PRETERM AND SEVERLY PRETERM NEONATES AT A PERIPHERAL MILITARY HOSPITAL

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i4.3343 ◽

2021 ◽

Vol 71 (4) ◽

pp. 1292-95

Author(s):

Sohail Aslam ◽

Fawad Ahmad Khan ◽

Omer Tufail ◽

Naila Mumtaz ◽

Syed Uzair Maqsood ◽

...

Keyword(s):

Serum Calcium ◽

Gestational Age ◽

Venous Blood ◽

Military Hospital ◽

Preterm Neonates ◽

Total Serum ◽

Cross Sectional ◽

Very Preterm ◽

Total Serum Calcium ◽

Extremely Preterm

Objective: To determine the frequency and compare serum calcium levels amongst extremely preterm and very preterm neonates. Study Design: Comparative cross sectional study. Place and Duration of Study: Combined Military Hospital, Multan Pakistan, from May to Oct 2018. Methodology: A total of 217 preterm neonates, born at Combined Military Hospital Multan up to the gestational age of 32 weeks completed from last menstrual period, were included in the study. They were divided in to two group’s i.e. very preterm and extremely preterm neonates. Those born between 28-32 weeks completed of gestation were categorized as severely preterm. Extremely preterm were those born between 24-28 weeks completed of gestation. Venous blood samples were acquired at approximately 36 hours after birth and total serum calcium levels were analyzed. Neonates having total serum calcium levels <7 mg/dL were declared as suffering from hypocalcaemia. Results: Out of 217 neonates, 117 (53.9%) were male while 100 (46.1%) were female. Mean gestational age was 30.98 ± 2.12 weeks while mean parity of the mothers was 2.82 ± 1.08 children. Mean birth weight was 1510.26 ± 142.38 grams. One hundred and seventeen (53.9%) of the preterm neonates suffered from hypocalcaemia with the mean total serum calcium level being 6.58 ± 0.86 mg/dL. Hypocalcaemia was more common in extremely preterm neonates compared to very preterm neonates (p<0.05). Conclusion: Hypocalcaemia is a frequent complication encountered in preterm neonates born between 24-32 weeks gestation. Within these neonates, the frequency of hypocalcaemia is higher in extremely preterm compared to severely preterm babies.

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Temporal Trends of Acute Kidney Injury and Associated Risk Exposures in Extremely Preterm Infants

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.19301220 ◽

2021 ◽

pp. CJN.19301220

Author(s):

Chih-Chia Chen ◽

Yung-Chieh Lin ◽

Shan-Tair Wang ◽

Chao-Ching Huang ◽

Keyword(s):

Serum Creatinine ◽

Preterm Infants ◽

Gestational Age ◽

Temporal Trends ◽

Content Type ◽

Very Preterm ◽

Extremely Preterm ◽

Extremely Preterm Infants ◽

Preterm Group ◽

Care Practices

Background and objectivesNeonatal AKI in the preterm population is an under-recognized morbidity. Detecting AKI in preterm infants is important for their long-term kidney health. We aimed to examine the yearly trends of incidence and the related morbidities and care practices affecting the occurrence of neonatal AKI in extremely preterm (gestational age <29 weeks) and very preterm (gestational age 29–32 weeks) infants.Design, setting, participants, & measurementsThe trends and the related risk factors and care practices of AKI were examined in the extremely preterm (n=434) and very preterm (n=257) infants who were admitted within 14 days after birth from 2005 to 2018 to the University Hospital and had at least two serum creatinine measurements during hospitalization. We defined AKI as a serum creatinine rise of 0.3 mg/dl or more within 48 hours or a 1.5-fold increase within 7 days.ResultsThe extremely preterm group had a three-fold higher incidence of AKI (30% versus 10%) than the very preterm group. Among preterm infants with AKI, 92% had one episode of AKI, and 45% experienced stage 2 or 3 AKI; the mean duration of AKI was 12±9 days. Across the 14-year period, the crude incidence of AKI declined markedly from 56% to 17% in the extremely preterm group and from 23% to 6% in the very preterm group. After adjustment, a significant decline of AKI incidence was still observed in the extremely preterm group. The declining AKI in the extremely preterm infants was related to the trends of decreasing incidences of neonatal transfer, prolonged aminoglycoside exposure, prophylactic use of nonsteroidal anti-inflammatory drugs, and sepsis.ConclusionsWe observed a declining trend in the incidence of neonatal AKI among extremely preterm infants from 2005 to 2018, which may be related to improvement of care practices.

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