scholarly journals Can EEG accurately predict 2-year neurodevelopmental outcome for preterm infants?

2021 ◽  
pp. fetalneonatal-2020-319825
Author(s):  
Rhodri O Lloyd ◽  
John M O'Toole ◽  
Vicki Livingstone ◽  
Peter M Filan ◽  
Geraldine B Boylan
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Infant Development ◽  
Strong Predictor ◽  
Characteristic Curve ◽  
Neurodevelopmental Outcome ◽  
Neonatal Morbidity ◽  
Clinical Score ◽  
Cranial Ultrasound ◽  
Time Points

ObjectiveEstablish if serial, multichannel video electroencephalography (EEG) in preterm infants can accurately predict 2-year neurodevelopmental outcome.Design and patientsEEGs were recorded at three time points over the neonatal course for infants <32 weeks’ gestational age (GA). Monitoring commenced soon after birth and continued over the first 3 days. EEGs were repeated at approximately 32 and 35 weeks’ postmenstrual age (PMA). EEG scores were based on an age-specific grading scheme. Clinical score of neonatal morbidity risk and cranial ultrasound imaging were completed.SettingNeonatal intensive care unit at Cork University Maternity Hospital, Ireland.Main outcome measuresBayley Scales of Infant Development III at 2 years’ corrected age.ResultsSixty-seven infants were prospectively enrolled in the study and 57 had follow-up available (median GA 28.9 weeks (IQR 26.5–30.4)). Forty had normal outcome, 17 had abnormal outcome/died. All EEG time points were individually predictive of abnormal outcome; however, the 35-week EEG performed best. The area under the receiver operating characteristic curve (AUC) for this time point was 0.91 (95% CI 0.83 to 1), p<0.001. Comparatively, the clinical course AUC was 0.68 (95% CI 0.54 to 0.80, p=0.015), while abnormal cranial ultrasound was 0.58 (95% CI 0.41 to 0.75, p=0.342).ConclusionMultichannel EEG is a strong predictor of 2-year outcome in preterm infants particularly when recorded around 35 weeks’ PMA. Infants at high risk of brain injury may benefit from early postnatal EEG recording which, if normal, is reassuring. Postnatal clinical complications can contribute to poor outcome; therefore, we state that a later EEG around 35 weeks has a role to play in prognostication.

Effects of Early Intervention and Stimulation on the Preterm Infant

PEDIATRICS ◽  
1980 ◽  
Vol 66 (1) ◽  
pp. 83-90
Author(s):  
Susan A. Leib ◽  
D. Gary Benfield ◽  
John Guidubaldi
Keyword(s):  
Weight Gain ◽  
Early Intervention ◽  
Treatment Group ◽  
High Risk ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Infant Development ◽  
Intervention Program ◽  
Control Group ◽  
Enrichment Program

To test the hypothesis that early intervention can enhance the development of high-risk preterm infants, a prescribed multimodal sensory enrichment program, within a regional neonatal intensive care unit, was designed and implemented. Twenty-eight appropriate-for-gestational age infants with birth weights between 1,200 and 1,800 gm were selected for study. To prevent control group contamination by the enrichment procedure, the first 14 infants were designated as the control group, and the next 14 as the treatment group. Treated infants had significantly higher developmental status than control infants, as measured by the Bayley Scales of Infant Development, at six months past the maternal expected date of confinement (F = 14.98, P &lt; .001, and F = 16.46, P &lt; .001 for the mental and motor scales, respectively). Mean infant weight gain per day and mean total weight gain during the hospitalization were not significantly different for the two groups although the treatment group received significantly less calories per kilogram per day than the control group (F = 9.02 P &lt; .006). Our data suggest that a prescribed intervention program for high-risk preterm infants appears to enhance the quality of development as measured at six months past the expected date of confinement. Further studies are necessary to determine the long-term value of early intervention and the apparent ability of infants receiving an enrichment program to utilize calories more efficiently than control infants.

Periventricular Echodensities Detected by Cranial Ultrasonography: Usefulness in Predicting Neurodevelopmental Outcome in Low-Birth-Weight, Preterm Infants

PEDIATRICS ◽  
1990 ◽  
Vol 85 (3) ◽  
pp. 400-404
Author(s):  
Forrest C. Bennett ◽  
Gail Silver ◽  
Edna J. Leung ◽  
Laurence A. Mack
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Intracranial Hemorrhage ◽  
Neonatal Intensive Care ◽  
Infant Development ◽  
Neurodevelopmental Outcome ◽  
Wide Range ◽  
Serial Scanning ◽  
Conventional Manner ◽  
Cranial Ultrasonography

Forty-eight low-birth-weight, preterm graduates of the University of Washington's neonatal intensive care unit who had received periodic, serial scanning by means of cranial ultrasonography during the first 4 to 6 weeks of life were longitudinally observed in an interdisciplinary neurodevelopmental follow-up program to a mean corrected age of 18 months. Mean birth weight for the sample was 1286 g; mean gestational age was 29 weeks. Periventricular echodensities were graded from 0 to 3, with 0 indicating no densities and 3 indicating cystic formation. Intracranial hemorrhage was graded in the conventional manner from 0 to IV. Neurodevelopmental outcome was assessed by means of a neurologic examination and the Bayley Scales of Infant Development. To synthesize the results, neurodevelopmental outcome for each subject was classified as normal, demonstrating minor abnormalities, or demonstrating major abnormalities. Multiple statistical analyses with various subgroupings of subjects consistently indicated severe intracranial hemorrhage (grades III and/or IV) to be a better predictor of overall neurodevelopmental outcome than grade of periventricular echodensity, including small cysts. These results suggest a wide range of outcomes after detection of periventricular echodensities and caution against communicating overly pessimistic prognoses in many cases.

scholarly journals Longitudinal Study of music Therapy’s Effectiveness for Premature infants and their caregivers (LongSTEP): protocol for an international randomised trial

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e025062 ◽  
Author(s):  
Claire Ghetti ◽  
Łucja Bieleninik ◽  
Mari Hysing ◽  
Ingrid Kvestad ◽  
Jörg Assmus ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Infant Development ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Developmentally Appropriate ◽  
Well Being ◽  
Positive Effects ◽  
Implementation And Dissemination ◽  
Randomised Controlled

IntroductionPreterm birth has major medical, psychological and socioeconomic consequences worldwide. Music therapy (MT) has positive effects on physiological measures of preterm infants and maternal anxiety, but rigorous studies including long-term follow-up are missing. Drawing on caregivers’ inherent resources, this study emphasises caregiver involvement in MT to promote attuned, developmentally appropriate musical interactions that may be of mutual benefit to infant and parent. This study will determine whether MT, as delivered by a qualified music therapist during neonatal intensive care unit (NICU) hospitalisation and/or in home/municipal settings following discharge, is superior to standard care in improving bonding between primary caregivers and preterm infants, parent well-being and infant development.Methods and analysisDesign:international multicentre, assessor-blind, 2×2 factorial, pragmatic randomised controlled trial; informed by a completed feasibility study.Participants:250 preterm infants and their parents.Intervention:MT focusing on parental singing specifically tailored to infant responses, will be delivered during NICU and/or during a postdischarge 6-month period.Primary outcome:changes in mother–infant bonding at 6-month corrected age (CA), as measured by the Postpartum Bonding Questionnaire.Secondary outcomes: mother–infant bonding at discharge and at 12-month CA; child development over 24 months; and parental depression, anxiety and stress, and infant rehospitalisation, all over 12 months.Ethics and disseminationThe Regional Committees for Medical and Health Research Ethics approved the study (2018/994/REK Nord, 03 July 2018). Service users were involved in development of the study and will be involved in implementation and dissemination. Dissemination of findings will apply to local, national and international levels.Trial registration numberNCT03564184

Association between Umbilical Catheters and Neonatal Outcomes in Extremely Preterm Infants

2017 ◽  
Vol 35 (03) ◽  
pp. 233-241
Author(s):  
Mohamed Elboraee ◽  
Jennifer Toye ◽  
Xiang Ye ◽  
Prakesh Shah ◽  
Khalid Aziz ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Neonatal Morbidity ◽  
Neonatal Intensive Care Units ◽  
Design Data ◽  
Major Morbidity ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Umbilical Catheters ◽  
Multivariable Analyses

Objective The objective of this study was to examine the association between umbilical catheters and a composite outcome of mortality or major neonatal morbidity in extremely preterm infants. Study Design Data were abstracted from the Canadian Neonatal Network database for infants born at <29 weeks' gestational age and admitted to 29 neonatal intensive care units between January 2010 and December 2012. Four groups were identified: those with no umbilical catheters, umbilical venous catheters (UVCs), umbilical artery catheters (UACs), and those with both UVCs and UACs. The outcomes were compared among the groups using univariate and multivariable analyses. Results Of 4,623 eligible infants, 820 (17.7%) had no catheters, 1,032 (22.3%) a UVC only, 120 (2.6%) a UAC only, and 2,651 (57.3%) had both catheters. After adjustment for acuity and other potential confounders, umbilical catheters were associated with higher odds of mortality or any major morbidity (UVC vs. no catheter: adjusted odds ratio [aOR]: 1.47; 95% CI: 1.18–1.85; UAC vs. no catheter: aOR: 1.67; 95% CI: 1.05–2.63; and both UVC + UAC vs. no catheter: aOR: 2.17; 95% CI: 1.79–2.70). Conclusion Most of the infants born at <29 weeks' gestation had UVC and/or UAC placement. The presence of either catheter was associated with mortality or major morbidity, and the association was stronger when both catheters were present.

scholarly journals Sequential Cranial Ultrasound and Cerebellar Diffusion Weighted Imaging Contribute to the Early Prognosis of Neurodevelopmental Outcome in Preterm Infants

PLoS ONE ◽  
2014 ◽  
Vol 9 (10) ◽  
pp. e109556 ◽  
Author(s):  
Margaretha J. Brouwer ◽  
Britt J. M. van Kooij ◽  
Ingrid C. van Haastert ◽  
Corine Koopman-Esseboom ◽  
Floris Groenendaal ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Diffusion Weighted Imaging ◽  
Neurodevelopmental Outcome ◽  
Cranial Ultrasound ◽  
Diffusion Weighted

scholarly journals Neurodevelopmental Outcome Among Multiples and Singletons: A Regional Neonatal Intensive Care Unit's Experience in Turkey

2013 ◽  
Vol 16 (2) ◽  
pp. 614-618 ◽  
Author(s):  
Zeynep Eras ◽  
Banu Mutlu Ozyurt ◽  
Gozde Kanmaz ◽  
Omer Erdeve ◽  
Evrim Durgut Sakrucu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Neurodevelopmental Outcome ◽  
Index Score ◽  
Multiple Gestation ◽  
Increased Risk ◽  
Developmental Index ◽  
Neurodevelopmental Impairment ◽  
A Prospective Study

Objective: The aim of this study was to compare the neurodevelopmental outcome at 12–18 months’ corrected age between multiples and singleton preterm infants. Methods: We designed a prospective study of preterm infants (≤32 weeks gestation) born and hospitalized in the neonatal intensive care unit between November 2008 and November 2009, whose assessments were performed at 12–18 months’ corrected age. Neurodevelopmental impairment was defined as the presence of any one of the following: moderate or severe cerebral palsy, severe bilateral hearing loss or bilateral blindness, mental developmental index score, or psychomotor developmental index score less than 70. Results were compared for both multiples and singleton infants. Results: One hundred and fifty-nine multiples and 211 singleton infants were assessed at 12–18 months’ corrected age. The neurodevelopmental outcome including all parameters at 12–18 months’ corrected age in multiples was not significantly different from singleton preterm infants. Conclusions: Multiple gestation in preterm infants is not associated with an increased risk of neurodevelopmental impairment at 12–18 months’ corrected age compared with singleton preterm infants. For further information, long term and high participation in neurodevelopmental follow-up and evaluation at pre-school age will be needed.

scholarly journals Influence of Maternal Preeclampsia on Neurodevelopmental Outcomes of Preterm Infants

2018 ◽  
Vol 24 (2) ◽  
pp. 99
Author(s):  
Halil Degirmencioglu ◽  
Birgul Say ◽  
Zeynep Ustunyurt ◽  
Serife Suna Oguz
Keyword(s):  
Cerebral Palsy ◽  
Preterm Infants ◽  
Gestational Age ◽  
Infant Development ◽  
Neurodevelopmental Outcome ◽  
Control Group ◽  
Neurodevelopmental Outcomes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Mean

<p><strong>Objective:</strong> The aim of this study was to determine the neurodevelopmental outcome of preterm infants born to mothers with preeclampsia and to compare them with preterm controls.</p><p><strong>Study design:</strong> This was a retrospective, observational study in a large, tertiary, neonatal intensive care unit. Neurodevelopmental evaluations using Bayley Scales of Infant Development II were performed in 226 two-year-old infants with birth weight ≤1500 g and gestational age ≤32 weeks who were born to mothers with preeclampsia and in 493 infants who were born after normotensive pregnancies, matched for gestational age and gender.</p><p><strong>Results:</strong> The mean gestational ages of the infants in the preeclampsia and control groups were 29.9±2.3 weeks and 28.7±4.1 weeks, respectively (p&lt;0.001). A total of 372 infants with a mean age of 19.2±3.2 months were assessed for long-term outcome. The mean mental developmental index score was significantly higher, and the percentage of infants with cerebral palsy was significantly lower, in the preeclampsia group compared with the control group (p=0.03 and p=0.02, respectively). However, no overall significant differences in neurodevelopmental impairment rates were found between the two groups (p=0.08).</p><p><strong>Conclusion:</strong> Maternal preeclampsia seems to be a protector factor for the development of cerebral palsy in preterm infants.</p>

scholarly journals Does ventricle size contribute to cognitive outcomes in posthemorrhagic hydrocephalus? Role of early definitive intervention

2021 ◽  
pp. 1-11
Author(s):  
Mounica Paturu ◽  
Regina L. Triplett ◽  
Siddhant Thukral ◽  
Dimitrios Alexopoulos ◽  
Christopher D. Smyser ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Brain Mri ◽  
Neurodevelopmental Outcome ◽  
Optimal Time ◽  
Preterm Neonates ◽  
Third Ventriculostomy ◽  
Cranial Ultrasound ◽  
Ventricular Size ◽  
Posthemorrhagic Hydrocephalus ◽  
Ventricle Size

OBJECTIVE Posthemorrhagic hydrocephalus (PHH) is associated with significant morbidity, smaller hippocampal volumes, and impaired neurodevelopment in preterm infants. The timing of temporary CSF (tCSF) diversion has been studied; however, the optimal time for permanent CSF (pCSF) diversion is unknown. The objective of this study was to determine whether cumulative ventricle size or timing of pCSF diversion is associated with neurodevelopmental outcome and hippocampal size in preterm infants with PHH. METHODS Twenty-five very preterm neonates (born at ≤ 32 weeks’ gestational age) with high-grade intraventricular hemorrhage (IVH), subsequent PHH, and pCSF diversion with a ventriculoperitoneal shunt (n = 20) or endoscopic third ventriculostomy (n = 5) were followed until 2 years of age. Infants underwent serial cranial ultrasounds from birth until 1 year after pCSF diversion, brain MRI at term-equivalent age, and assessment based on the Bayley Scales of Infant and Toddler Development, Third Edition, at 2 years of age. Frontooccipital horn ratio (FOHR) measurements were derived from cranial ultrasounds and term-equivalent brain MRI. Hippocampal volumes were segmented and calculated from term-equivalent brain MRI. Cumulative ventricle size until the time of pCSF diversion was estimated using FOHR measurements from each cranial ultrasound performed prior to permanent intervention. RESULTS The average gestational ages at tCSF and pCSF diversion were 28.9 and 39.0 weeks, respectively. An earlier chronological age at the time of pCSF diversion was associated with larger right hippocampal volumes on term-equivalent MRI (Pearson’s r = −0.403, p = 0.046) and improved cognitive (r = −0.554, p = 0.047), motor (r = −0.487, p = 0.048), and language (r = −0.414, p = 0.021) outcomes at 2 years of age. Additionally, a smaller cumulative ventricle size from birth to pCSF diversion was associated with larger right hippocampal volumes (r = −0.483, p = 0.014) and improved cognitive (r = −0.711, p = 0.001), motor (r = −0.675, p = 0.003), and language (r = −0.618, p = 0.011) outcomes. There was no relationship between time to tCSF diversion or cumulative ventricle size prior to tCSF diversion and neurodevelopmental outcome or hippocampal size. Finally, a smaller cumulative ventricular size prior to either tCSF diversion or pCSF diversion was associated with a smaller ventricular size 1 year after pCSF diversion (r = 0.422, p = 0.040, R2 = 0.178 and r = 0.519, p = 0.009, R2 = 0.269, respectively). CONCLUSIONS In infants with PHH, a smaller cumulative ventricular size and shorter time to pCSF diversion were associated with larger right hippocampal volumes, improved neurocognitive outcomes, and reduced long-term ventriculomegaly. Future prospective randomized studies are needed to confirm these findings.

scholarly journals Correlation of Thompson Score in Predicting Early Outcome of Newborn with Birth Asphyxia

2020 ◽  
Vol 18 (3) ◽  
pp. 406-410
Author(s):  
Sabina Shrestha ◽  
Sangita Puree Dhungana ◽  
Sujit Shrestha ◽  
Gentle Sunder Shrestha
Keyword(s):  
Neurodevelopmental Outcome ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Clinical Score ◽  
Hypoxic Ischemic Encephalopathy ◽  
Early Outcome ◽  
Medical College ◽  
A Prospective Study ◽  
Ischemic Encephalopathy

Background: Birth asphyxia is one of the important causes of neonatal morbidity and mortality, accounting up to 30% of neonatal death in Nepal. It is also an important cause of long term neurological disability and impairment. Thompson encephalopathy score is a clinical score which can be used to assess the newborn with hypoxic ischemic encephalopathy for the prognosis and their neurodevelopmental outcome. The aim of the study was to assess the role of Thompson score in predicting the early outcome of neonates with birth asphyxia. Methods: A prospective study was conducted from May 2019 to April 2020 in Nepal Medical College. All the term babies during the period with Apgar score of less than seven at five minutes were considered to have birth asphyxia and included in the study. Neurological examination was done on first, second and third day using HIE score proposed by Thompson and severity of hypoxic ischemic encephalopathy was classified accordingly. Outcome was measured as normal, morbidity with encephalopathy, seizure, organ dysfunction and death. Results: Out of 391 newborn admitted to neonatal unit, 84 (21.4%) had birth asphyxia. Mild Thompson score on day 1,2,3 were 49(58.3%), 49 (58.3%), 51(60.7%); moderate Thompson score on day 1,2,3 were 21 (25%), 21 (25%), 18(21.4%) and severe Thompson score on day 1, 2, 3 were 14 (16.7%), 14 (16.7%), 15(17.9%) respectively. Out of 14 babies who had severe Thompson score on day 1, 11(91.7%) expired and 3 (16.7%) developed encephalopathy. Conclusions: There was strong correlation of severity of Thompson score with the outcome. Keywords: Birth asphyxia; hypoxic ischemic encephalopathy; thompson score

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