scholarly journals Factors affecting survival and outcome at 3 years in extremely preterm infants.

1994 ◽  
Vol 71 (1) ◽  
pp. F28-F31 ◽  
Author(s):  
R W Cooke
Keyword(s):  
Logistic Regression ◽  
Cerebral Haemorrhage ◽  
Factors Affecting ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Cerebral Ultrasound ◽  
Male Sex ◽  
Lost To Follow Up ◽  
Ultrasound Evidence

A total of 823 infants born at 28 weeks' gestation or less were admitted to a regional referral unit between 1980 and 1989. Four hundred and sixty five (56.5%) survived to be discharged home. Twenty one subsequently died and two were lost to follow up. Four hundred and forty two (53.7%) were assessed for disabilities at the age of 3 years. Eighty four (19%) had major disabilities, of which 40 (9%) were severe. A further 39 (9%) had lesser disabilities. Three hundred and nineteen (63%) survivors appeared to be functioning normally. Logistic regression showed the likelihood of survival to be independently related to gestational age, birthweight ratio, and more recent year of birth, and inversely related to male sex and ultrasound evidence of cerebral haemorrhage or infarction. The likelihood of later disability in survivors was only independently related to cerebral ultrasound appearances.

scholarly journals Association between Neonatal Intakes and Hyperglycemia, and Left Heart and Aortic Dimensions at 6.5 Years of Age in Children Born Extremely Preterm

2021 ◽  
Vol 10 (12) ◽  
pp. 2554
Author(s):  
Jawwad Hamayun ◽  
Lilly-Ann Mohlkert ◽  
Elisabeth Stoltz Sjöström ◽  
Magnus Domellöf ◽  
Mikael Norman ◽  
...  
Keyword(s):  
Interventricular Septum ◽  
Posterior Wall ◽  
Root Diameter ◽  
Left Ventricular ◽  
Left Heart ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Nutritional Data ◽  
Aortic Dimensions

Survivors of extremely preterm birth (gestational age < 27 weeks) have been reported to exhibit an altered cardiovascular phenotype in childhood. The mechanisms are unknown. We investigated associations between postnatal nutritional intakes and hyperglycemia, and left heart and aortic dimensions in children born extremely preterm. Postnatal nutritional data and echocardiographic dimensions at 6.5 years of age were extracted from a sub-cohort of the Extremely Preterm Infants in Sweden Study (EXPRESS; children born extremely preterm between 2004–2007, n = 171, mean (SD) birth weight = 784 (165) grams). Associations between macronutrient intakes or number of days with hyperglycemia (blood glucose > 8 mmol/L) in the neonatal period (exposure) and left heart and aortic dimensions at follow-up (outcome) were investigated. Neonatal protein intake was not associated with the outcomes, whereas higher lipid intake was significantly associated with larger aortic root diameter (B = 0.040, p = 0.009). Higher neonatal carbohydrate intake was associated with smaller aorta annulus diameter (B = −0.016, p = 0.008). Longer exposure to neonatal hyperglycemia was associated with increased thickness of the left ventricular posterior wall (B = 0.004, p = 0.008) and interventricular septum (B = 0.004, p = 0.010). The findings in this study indicate that postnatal nutrition and hyperglycemia may play a role in some but not all long-lasting developmental adaptations of the cardiovascular system in children born extremely preterm.

Factors affecting parents' presence with their extremely preterm infants in a neonatal intensive care room

2013 ◽  
Vol 102 (7) ◽  
pp. 695-702 ◽  
Author(s):  
Ann-Britt Heinemann ◽  
Lena Hellström-Westas ◽  
Kerstin Hedberg Nyqvist
Keyword(s):  
Intensive Care ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Factors Affecting ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Neurodevelopmental Outcomes after Neonatal Mechanical Ventilation

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Eman Ahmed Zaky ◽  
Hebatallah AM Shaaban ◽  
Mohamed OA Dawoud ◽  
Kareem SEF Madbouly ◽  
Shaymaa M Deifalla
Keyword(s):  
Mechanical Ventilation ◽  
Rating Scale ◽  
Neurodevelopmental Outcomes ◽  
Neurodevelopmental Delay ◽  
Increased Risk ◽  
Study Results ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Significant Difference

Abstract Background A majority of extremely preterm infants are treated with mechanical ventilation, which is associated with an increased risk for future development of chronic lung disease, neonatal brain damage, and neurodevelopmental impairments. Objectives The aim of the current study was to evaluate the current and follow up neurodevelopmental status of an Egyptian sample of newly and previously discharged mechanically ventilated infants following them up for a period of 6 months for the earlier group and a year for the latter. Patients and Methods The current study was designed to be a descriptive study with retrospective (50 infants) and prospective (50 infants) domains. It was carried out on 100 neonates who were recruited from the Pediatric Neonatology Clinic, Children's Hospital and Neonatal Intensive Care Unit, Ain Shams University using clinical evaluation, Bayley Scales of Infant Development, and Childhood Autism Rating Scale (CARS).. Results There was statistically significant negative correlation between CARS score and Bayley Scale by using Composite Score (Cognitive, Language and Motor) on first assessment and follow up in the Prospective group while no correlation was found in the retrospective group. The study results showed that there was no statistical significant difference between two groups as regards gestational age, gender, residency, consanguinity, maternal disease, maturity, mode of delivery, respiratory distress, duration of stay in NICU, duration on mechanical ventilation, weight on admission, audiometry and fundus examination (P &gt; 0.05). Conclusion Using a mechanical ventilator in the neonatal period for a prolonged duration increased the risk for ASD and neurodevelopmental delay. Future studies on large samples are recommended from multicenters to confirm the validity of such findings, Bayley scale is a predicative for neurodevelopmental delay in neonates with long duration stay at NICU especially preterms with low birth weight.

Pulmonary and Neurological Follow-Up of Extremely Preterm Infants

Neonatology ◽  
2010 ◽  
Vol 97 (4) ◽  
pp. 388-394 ◽  
Author(s):  
Lex W. Doyle ◽  
Peter J. Anderson
Keyword(s):  
Preterm Infants ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

scholarly journals Outcome of traumatic Extradural Hematoma (EDH) using Glasgow Outcome Scale (GOS)

2018 ◽  
Vol 5 (10) ◽  
pp. 3327
Author(s):  
Dixit V. Prajapati ◽  
Nimish J. Shah
Keyword(s):  
Traffic Accident ◽  
Surgical Intervention ◽  
Road Traffic ◽  
Extradural Hematoma ◽  
Factors Affecting ◽  
Poor Outcome ◽  
Ct Head ◽  
Lost To Follow Up ◽  
Time Of Intervention

Background: Outcome in patient with EDH depends on various factors like GCS at presentation, Volume of hematoma, time of intervention, age, location of hematoma, etc. This study was carried out to find out correlation (if any) between outcome and various factors affecting it. Aim and objectives of this study were to study outcome of patients with traumatic EDH in terms of poor outcome (GOS score 1,2,3), Good outcome (GOS Score 4,5)Methods: This study was carried out in 91 patients having positive CT Head for EDH. Follow up was done every monthly up to 3 months. GOS was recorded at each follow up. Results: Road traffic accident was the most common mode of trauma. 16 patients were operated. Four patients died immediately after diagnosis of traumatic EDH, before doing any intervention. One patient died on 1st post-operative day. After one month, two patients were lost to follow up, 80 patients had GOS 5, four patients had GOS 4. At 2nd and 3rd month, 83 patients had GOS 5, one patient had GOS 4. 17 patients had GCS 3-8, among them, 11 patients had GOS 5, one patient had GOS 4 and five patients died (GOS 1). 15 patients had GCS 9-12, among them, 15 patients had GOS 5. 57 patients had GCS 13-15, among them, 54 patients had GOS 5. 69 patients had EDH volume <30 ml and all patients had GOS 5. 20 patients had EDH volume ≥30 ml, among them, 14 patients had GOS 5, one patient had GOS 4 and five patients died. Conclusions: GOS in EDH patient is affected by GCS and EDH volume at presentation. Lower GCS and larger EDH volume have poor outcome. Surgical intervention in larger EDH volume improves outcome.

scholarly journals Factors affecting the rates of adherence to surveillance recommendations for incidental pancreatic cystic lesions in a large urban safety net hospital

2020 ◽  
Vol 7 (1) ◽  
pp. e000430
Author(s):  
Andrew Canakis ◽  
Asaf Maoz ◽  
Jaroslaw N Tkacz ◽  
Christopher Huang
Keyword(s):  
Primary Care ◽  
Logistic Regression ◽  
Safety Net ◽  
Multivariate Logistic Regression Model ◽  
Cystic Lesions ◽  
Factors Affecting ◽  
Safety Net Hospital ◽  
Urban Safety ◽  
Access To Primary Care

BackgroundPancreatic cystic lesions (PCLs) are a heterogenous group of lesions with varying degrees of malignant potential. PCLs are often incidentally detected on imaging. Management for patients without an immediate indication for resection or tissue sampling entails radiographic surveillance to assess for features concerning for malignant transformation. This study aims to determine the rates of adherence to surveillance recommendations for incidental PCLs, and identify factors associated with adherence or loss of follow-up.MethodsWe conducted a single-centre retrospective study of patients at a tertiary safety net hospital with incidentally discovered asymptomatic PCLs. Follow-up was defined as having undergone repeat imaging as recommended in the radiology report. Data were analysed using logistic regression.ResultsWithin our cohort (n=172), 123 (71.5%) subjects completed follow-up imaging. Attending a gastroenterology appointment was most strongly associated with completing follow-up for PCLs and remained significant (p=0.001) in a multivariate logistic regression model. Subjects without a documented primary care provider were less likely to have follow-up (p=0.028). Larger cyst size was associated with completion of follow-up in univariate only (p=0.067).ConclusionWe found that follow-up of an incidentally discovered PCLs was completed in the majority of our subjects. Incomplete follow-up for PCLs occurred in up to one in three to four patients in our cohort. Access to primary care and utilisation of subspecialty gastroenterology care are associated with completion of follow-up for PCLs. If validated, our findings can guide potential interventions to improve follow-up rates for PCLs.

Safety of Allogenic Human Cord Blood Derived Mononuclear Cells for Extreme Preterms Infants at High Risk of Death: A Descriptive Study

2020 ◽  
Author(s):  
Jia Chen ◽  
Yabo Mei ◽  
Xue Du ◽  
Qiuping Li ◽  
Zizhen Wang ◽  
...  
Keyword(s):  
High Risk ◽  
Cord Blood ◽  
Preterm Infants ◽  
Mononuclear Cells ◽  
Human Umbilical Cord ◽  
Risk Of Death ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Risk Potential

Abstract Backgroud Extreme preterm infants are at a high risk for developing preterm complications and death. Despite advances in medical care, many survivors face a lifetime of disability. Objective To assess the short term safety of and four-year follow-up outcomes of allogenic, human umbilical cord blood (hUCB) derived mononuclear cells(MNCs) infusion to extreme preterm infants with high risk potential of death. Method This study was a phase I, open-label, single-arm, single-center trial to evaluate the safety of allogenic, hUCB-MNCs infusion for extreme preterm infants with high risk potential of death. HUCB MNCs characteristics, pre- and postinfusion vital signs and laboratory investigations were recorded. Temporal profiles of cytokines and growth factors from blood were test. Clinical data including mortality rates, preterm complications and follow-up outcomes were recorded. Results After processing, relatively MNCs mean (1.9±0.8) ×106/kg; volume mean (11.25±2.12)ml/kg were infused to 10 extremely preterm infants with high risk of death. No adverse effects were noticed during treatment. 40% received extubation and weaned to nasal CPAP successfully; 30% received lower FiO2; no infants suffered from late onset sepsis; 30% received poor response to MNCs infusion. 40% infants suffered from ROP and only one infant needed laser surgery. No patients suffered from NEC after MNCs infusion. All ten infants who received hUCB MNCs infusion survived inhospital and prevent deterioration of clinical features, but 4 infants discharged against the advice of the doctor by their parents and lost connection. Regarding the rest 6 infants, no home oxygen therapy and rehospitalization, no suffered from other long-term respiratory complications at visit 1～visit 3. One infant showed cerebral palsy at visit 1, no clinical evidence associated this with MNCs infusion. Blood level of HGF significantly increased, but MMP-9, IL-6, IL-8, TNF-α and TGF-β levels were significantly lower at 24h post infusion compared with baseline (P < 0.05).Conclusions Collection, preparation, and infusion of allogenic hUCB MNCs to extreme preterm infants is feasible and safe. Trial registration The study was registered on Chinese Clinical Trials.gov (NO. ChiCTR–OPN - 15006932). Registered 17 August 2015, http://www.chictr.org.cn/edit.aspx?pid=11662&htm=4.

scholarly journals Comparing Standardized and Parent-Reported Motor Outcomes of Extremely Preterm Infants

Children ◽  
2019 ◽  
Vol 6 (8) ◽  
pp. 90
Author(s):  
Maeve Morgan-Feir ◽  
Andrea Abbott ◽  
Anne Synnes ◽  
Dianne Creighton ◽  
Thevanisha Pillay ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Motor Impairment ◽  
Fine Motor ◽  
Chi Square ◽  
Increased Risk ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Ages And Stages Questionnaire ◽  
Motor Outcomes

Extremely preterm infants are at increased risk of motor impairment. The Canadian Neonatal Follow-Up Network (CNFUN) afforded an opportunity to study the outcomes of extremely preterm children. The purpose of this study was to compare 18-month corrected age (CA) motor outcomes of extremely preterm infants with parent-reported functional outcomes at 3 years CA. CNFUN data of 1376 infants were used to conduct chi-square analyses to compare Bayley-III motor scores (composite, gross, and fine motor) at 18 months CA with parent-reported Ages and Stages Questionnaire motor scores (gross and fine motor) at 3 years CA. The correlation of motor scores at 18-months CA with parent-reported gross and fine motor scores at 3 years CA was also examined. We found that 1 in 5 infants scoring within or above the average range on the Bayley-III had parent-reported functional fine and gross motor difficulties at 3 years CA. Bayley-III scores were only moderately correlated with functional motor outcomes. Results of the study suggest that the Bayley-III at 18 months CA was able to detect the majority of infants with motor problems, but not all; therefore, ongoing follow-up of extremely preterm infants is required. The Bayley-III motor composite score has greater clinical utility compared to sub-scale scores.

scholarly journals Influence Of Time Under Mechanical Ventilation On Bronchopulmonary Dysplasia Severity In Extremely Preterm Infants: A Pilot Study.

2020 ◽  
Author(s):  
Vanessa Suziane Probst ◽  
Victoria Escobar ◽  
Darllyana Soares ◽  
Jane Kreling ◽  
Ligia Ferrari ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Roc Curve ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Chi Square ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Abstract The relation between mechanical ventilation (MV) and bronchopulmonary dysplasia (BPD) is well stabilished, but is unknown, however, how much time under MV influences the severity of the disease. Aim: To define the duration under MV with greater chance to develop moderate to severe BPD (M/S BPD) in extremely PTNB and to compare clinical outcomes before and during hospitalization among patients with mild and M/S BPD. Methods: 53 PTNB were separated into mild and M/S BPD groups and their data were analyzed. Time under MV with a greater chance of developing M/S BPD was estimated by the ROC curve. Perinatal and hospitalization outcomes were compared between groups. A logistic regression was performed to verify the influence of variables associated to M/S BPD development, such as pulmonary hypertension (PH), gender, gestational age (GA) and weight at birth, as well the time under MV found with ROC curve. The result of ROC curve was validated using an independent sample (n=16) by Chi-square test. Results: Time under MV related to a greater chance of developing M/S BPD was 36 days. M/S BPD group had more males (14 vs 5, p=0,047), longer time under MV (43 vs 19 days, p<0,001), more individuals with PH (12 vs 3, p=0,016), worse retinopathy of prematurity (grade 3, 2 vs 11, p=0,003), longer hospital length of stay (109 vs 81,5 days, p<0,001), greater PMA (41 vs 38 weeks, p<0,001) and weight (2620 vs 2031 grams, p<0,001) at discharge and the mild BPD group had more CPAP use prior to MV (12 vs 7, p=0,043). Among all variables included in logistic regression, only PH and MV<36 days were significant in the model, explaining 72% of variation in M/S BPD development. In the validation sample, prevalence of preterm infants who needed MV for more than 36 days in the M/S BPD group was 100% (n=6) and 0% in mild BPD group (p=0,0001). Conclusion: Time under MV related to moderate to severe BPD development is 36 days, and worst outcomes are related to disease severity. PH and time under MV for more than 36 days are related to development of M/S BPD.

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