scholarly journals Relationship between the Quantitative Indicators of Cranial MRI and the Early Neurodevelopment of Preterm Infants

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jing Yin ◽  
Yanhui Wu ◽  
Yuxuan Shi ◽  
Lu Shen ◽  
Qigai Yin
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Characteristic Curve ◽  
Univariate Analysis ◽  
Neurodevelopmental Outcome ◽  
Binary Logistic Regression Analysis ◽  
Maternal Complications ◽  
Formula Group ◽  
Cranial Mri ◽  
Quantitative Indicators

Aim. To explore the relationship between the quantitative indicators (biparietal width, interhemispheric distance) of the cranial MRI for preterm infants at 37 weeks of postmenstrual age (PMA) and neurodevelopment at 6 months of corrected age. Methods. A total of 113 preterm infants (gestational age < 37 weeks) delivered in the Obstetrics Department of the First People’s Hospital of Lianyungang from September 2018 to February 2020 and directly transferred to the Neonatology Department for treatment were enrolled in this study. Based on their development quotient (DQ), the patients were divided into the normal ( DQ ≥ 85 , n = 76 ) group and the abnormal ( DQ < 85 , n = 37 ) group. Routine cranial MRI (cMRI) was performed at 37 weeks of PMA to measure the biparietal width (BPW) and interhemispheric distance (IHD). At the corrected age of 6 months, Development Screening Test (for children under six) was used to assess the participants’ neurodevelopment. Results. Univariate analysis showed statistically significant differences in BPW, IHD, and the incidence of bronchopulmonary dysplasia between the normal and the abnormal groups ( P < 0.05 ), while no statistically significant differences were found in maternal complications and other clinical conditions between the two groups ( P > 0.05 ). Binary logistic regression analysis demonstrated statistically significant differences in IHD and BPW between the normal and the abnormal groups (95% CI: 1.629-12.651 and 0.570-0.805, respectively; P = 0.004 and P < 0.001 , respectively), while no significant differences were found in the incidence of bronchopulmonary dysplasia between the two groups (95% CI: 0.669-77.227, P = 0.104 ). Receiver operating characteristic curve revealed that the area under the curve of BPW, IHD, and the joint predictor (BPW + IHD) were 0.867, 0.805, and 0.881, respectively (95% CI: 0.800-0.933, 0.710-0.900, and 0.819-0.943, respectively; all P values < 0.001). Conclusion. BPW and IHD, the two quantitative indicators acquired by cMRI, could predict the neurodevelopmental outcome of preterm infants at the corrected age of 6 months. The combination of the two indicators showed an even higher predictive value.

Human milk as a protective factor for bronchopulmonary dysplasia: a systematic review and meta-analysis

2018 ◽  
Vol 104 (2) ◽  
pp. F128-F136 ◽  
Author(s):  
Jinglan Huang ◽  
Li Zhang ◽  
Jun Tang ◽  
Jing Shi ◽  
Yi Qu ◽  
...  
Keyword(s):  
Human Milk ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Protective Factor ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Current Evidence ◽  
Inclusion Criteria ◽  
Formula Group ◽  
Milk Feeding

ObjectiveTo summarise current evidence evaluating the effects of human milk on the risk of bronchopulmonary dysplasia (BPD) in preterm infants.DesignWe searched for studies on human milk and BPD in English and Chinese databases on 26 July 2017. Furthermore, the references of included studies were also screened. The inclusion criteria in this meta-analysis were the following: (1) preterm infants (<37 weeks); (2) human milk; (3) comparing with formula feeding; (4) the outcome included BPD; and (5) the type of study was randomised controlled trial (RCT) or cohort study.ResultA total of 17 cohort studies and 5 RCTs involving 8661 preterm infants met our inclusion criteria. The ORs and 95% CIs of six groups were as follows: 0.78 (0.68 to 0.88) for exclusive human milk versus exclusive formula group, 0.77 (0.68 to 0.87) for exclusive human milk versus mainly formula group, 0.76 (0.68 to 0.87) for exclusive human milk versus any formula group, 0.78 (0.68 to 0.88) for mainly human milk versus exclusive formula group, 0.83 (0.69 to 0.99) for mainly human milk versus mainly formula group and 0.82 (0.73 to 0.93) for any human milk versus exclusive formula group. Notably, subgroup of RCT alone showed a trend towards protective effect of human milk on BPD but no statistical significance.ConclusionBoth exclusive human milk feeding and partial human milk feeding appear to be associated with lower risk of BPD in preterm infants. The quality of evidence is low. Therefore, more RCTs of this topic are needed.

scholarly journals Low-grade intraventricular hemorrhage and neurodevelopment at 24 months of age

2018 ◽  
Vol 28 (3) ◽  
pp. 29354
Author(s):  
Sara Peixoto ◽  
Joana Amaral ◽  
Cristina Resende ◽  
Dolores Faria ◽  
Adelaide Taborda
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Intraventricular Hemorrhage ◽  
Univariate Analysis ◽  
Neurodevelopmental Outcome ◽  
Male Gender ◽  
Low Grade ◽  
Antenatal Corticosteroid ◽  
The Impact ◽  
Cranial Ultrasonography

AIMS: To evaluate the impact of low-grade intraventricular hemorrhage on neurodevelopmental outcome in preterm infants at 24 months of age.METHODS: We conducted a retrospective case-control study of infants with gestational age less than 34 weeks, admitted to a Neonatal Intensive Care Unit between January/2006 and December/2015. Cases were defined as those with low-grade intraventricular hemorrhage (grades I or II), diagnosed by cranial ultrasonography. For each case, a control with the same gestational age but without intraventricular hemorrhage was selected. Follow-up examinations of neurodevelopment were performed at 24 months of age in cases and controls using the Griffiths Mental Development Scale. Cerebral palsy, neurodevelopmental delay (developmental quotient <2 side deviations below the mean), hearing impairment and/or blindness were considered as severe neurodevelopmental impairment.RESULTS: The study included 172 preterm infants: 86 cases and 86 controls. In the univariate analysis, a difference between the two groups was identified for the following clinical findings: antenatal corticosteroid complete cycle (57% in cases vs. 80% in controls; p=0.001; OR: 0.33, 95%CI 0.17-0.64); male gender (63% cases vs. 41% controls; p=0.004; OR: 2.45, 95%CI 1.3-4.5); outborn (26% cases vs. 9% controls; p=0.005; OR: 3.3 95%CI 1.4-8.0); Clinical Risk Index for Babies higher than 5 (24% in cases vs. 12% in controls; p=0.029; OR: 2.4 95%CI 1.1-5.6); intubation in the delivery room (47% cases vs. 27% controls; p=0.007; OR: 2.38 95%CI 1.3-4.5); and neonatal sepsis (34% in cases vs. 20% in controls; p=0.039; OR: 2.1 95%CI 1.03-4.1). After logistic regression, differences were only maintained for antenatal corticosteroid (p=0.005; OR 0.34, 95%CI 0.16-0.72) and male gender (p=0.002; OR 2.9, 95%CI 1.4-5.8). A severe neurodevelopmental deficit was present in three cases (3.5%) and one control (1.2%). No statistically significant differences in outcome were found between cases and controls.CONCLUSIONS: In this sample, preterm infants with low-grade intraventricular hemorrhage diagnosed by cranial ultrasonography had no difference in early neurodevelopmental outcome when compared with controls.

scholarly journals Neurodevelopmental outcome of preterm infants with bronchopulmonary dysplasia.

1995 ◽  
Vol 73 (3) ◽  
pp. F128-F134 ◽  
Author(s):  
P. H. Gray ◽  
Y. R. Burns ◽  
H. A. Mohay ◽  
M. J. O'Callaghan ◽  
D. I. Tudehope
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Neurodevelopmental Outcome

scholarly journals HIGH SYSTEMIC BLOOD PRESSURE IN PRETERM INFANTS WITH BRONCHOPULMONARY DYSPLASIA AND LONG-TERM OUTCOMES

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e20-e20
Author(s):  
Florence Cayouette ◽  
Sarah Spénard ◽  
Anie Lapointe ◽  
Véronique Dorval ◽  
Julie Sommer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Neurodevelopmental Outcome ◽  
Systemic Blood Pressure ◽  
Control Group ◽  
Neurodevelopmental Outcomes ◽  
Systemic Blood ◽  
Neurodevelopmental Impairment

Abstract BACKGROUND Bronchopulmonary dysplasia (BPD) is a known risk factor for neurodevelopmental impairment in preterm infants. BPD is also associated with an increased incidence of high systemic blood pressure (HBP). However, it is not known if a diagnosis of HBP in BPD patients relates to later neurodevelopmental outcomes. OBJECTIVES We aimed to determine the incidence of neonatal HBP diagnosis in a cohort of preterm infants born <29 weeks of gestational age (GA) with BPD. The secondary objective was to assess if a concomitant diagnosis of BPD and HBP influences neurodevelopmental outcomes at 18 months. DESIGN/METHODS We performed a single center retrospective study using data from medical charts. All infants born <29 weeks GA admitted to our level-IV neonatal intensive care unit between January 2010 and December 2012 diagnosed with BPD at 36 weeks of corrected GA were included. Patients transferred before 36 weeks of corrected GA, that died before 18 months or had congenital anomalies were excluded. Patients were classified in the HBP group if HBP was a documented diagnosis in the chart. The control group was the remaining patients with BPD at 36 weeks corrected GA but without HBP. Severe neurodevelopmental impairment at 18 months was defined as either any Bailey-III score <70, cerebral palsy or severe hearing or visual impairment. Descriptive statistics for prenatal and postnatal patients’ characteristics were analyzed. Logistic regression was performed for factors associated with long-term disability. Level of significance was determined as a p value <0.05. RESULTS During the study period, 337 preterm infants <29 weeks of GA were identified and after exclusions, 98 newborns met the criteria of BPD at 36 weeks corrected GA. Mean GA and mean birth weight were 26.7 ± 1.7 weeks and 882 ± 199 g respectively. The majority were males (57%) and received antenatal steroids (87.8%). We identified twenty-five newborns (25.5%) with a diagnosis of HBP. Demographic data was similar between the 2 groups. 56% of the HBP group received a post-natal course of steroids, compared to 36% for the control group (p 0.07). The neurodevelopmental outcome at 18 months was similar between the two groups (p 0.54) and was not influenced by the presence of a HBP diagnosis after regression analysis (p 0.8). CONCLUSION The diagnosis of HBP was frequent in our cohort of preterm infants born <29 weeks GA with BPD but did not seem to be related to long-term neurodevelopmental outcomes.

scholarly journals Association between probiotics and bronchopulmonary dysplasia in preterm infants

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yangming Qu ◽  
Shijie Guo ◽  
Ying Liu ◽  
Guohua Wang ◽  
Hui Wu
Keyword(s):  
Logistic Regression ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Univariate Analysis ◽  
Invasive Mechanical Ventilation ◽  
Maternal Diabetes ◽  
Categorical Variables ◽  
Regression Result ◽  
Multivariate Logistic Regression

AbstractBronchopulmonary dysplasia is a chronic pulmonary disease with a high incidence in premature infants, and there is still no effective treatment. The purpose of our study was to analyze the association between the use of probiotics and BPD in premature infants. We retrospectively collected clinical data of infants with gestational age < 32 weeks admitted to the NICU of The First Hospital of Jilin University from January 1, 2019 to March 31, 2020. Demographic and clinicopathological data of the inclusion population were collected. The outcome was the incidence of BPD or death. The χ2 tests was used to compare the categorical variables. The t test and non-parametric Wilcoxon rank-sum test were used to compare the continuous data. Univariate and multivariate logistic regression were used to analyze the association between probiotics and BPD. A total of 318 newborns met the inclusion criteria, of which 94 received probiotics and 224 received no probiotics. There were 16 deaths and 115 newborns with BPD in the included population. The results of univariate analysis showed differences in the maternal diabetes, the proportion of systemic antibiotics given to mother within 24 h before birth, the receiving rate of invasive mechanical ventilation, the prevalence of BPD/death, PDA, RDS and Ivh between newborns with and without probiotics (p < 0.05); The results of unadjusted univariate logistic regression model showed that probiotic (OR 0.034, 95% CI 0.012–0.096) was the factor affecting BPD in preterm infants (p < 0.05). Multivariate logistic regression result (OR 0.037, 95% CI 0.013–0.105) was consistent with univariate analysis (P < 0.001). Probiotics are associated with a reduced risk of BPD in preterm infants < 32 weeks of age. More prospective studies with large samples are still needed.

scholarly journals Risk factors for recurrent wheezing in preterm infants who received prophylaxis with palivizumab

2021 ◽  
pp. e20210157
Author(s):  
Mariana Bueno Manini1 ◽  
Natasha Yumi Matsunaga1,2 ◽  
Lívea Gianfrancesco1,2 ◽  
Marina Simões Oliveira1,2 ◽  
Maria Rosa Vieira de Carvalho3 ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Care Center ◽  
Univariate Analysis ◽  
Recurrent Wheezing ◽  
Cross Sectional ◽  
History Of ◽  
Syncytial Virus

Objective: To determine the prevalence of recurrent wheezing (RW) in preterm infants who received prophylaxis against severe infection with respiratory syncytial virus (RSV) and to identify genetic susceptibility (atopy or asthma) and risk factors for RW. Methods: This was a cross-sectional study involving preterm infants who received prophylaxis with palivizumab at a referral center in Brazil during the first two years of age. A structured questionnaire was administered in a face-to-face interview with parents or legal guardians. Results: The study included 410 preterm infants (median age = 9 months [0-24 months]). In the sample as a whole, 111 children (27.1%; [95% CI, 22.9-31.5]) had RW. The univariate analysis between the groups with and without RW showed no differences regarding the following variables: sex, ethnicity, maternal level of education, gestational age, birth weight, breastfeeding, number of children in the household, day care center attendance, pets in the household, and smoking caregiver. The prevalence of RW was twice as high among children with bronchopulmonary dysplasia (adjusted OR = 2.08; 95% CI, 1.11-3.89; p = 0.022) and almost five times as high among those with a personal/family history of atopy (adjusted OR = 4.96; 95% CI, 2.62-9.39; p < 0.001) as among those without these conditions. Conclusions: Preterm infants who received prophylaxis with palivizumab but have a personal/family history of atopy or bronchopulmonary dysplasia are more likely to have RW than do those without these conditions.

scholarly journals A Comparison of KL-6 and Clara Cell Protein as Markers for Predicting Bronchopulmonary Dysplasia in Preterm Infants

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Keyi Wang ◽  
Xianmei Huang ◽  
Hui Lu ◽  
Zhiqun Zhang
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Predictive Power ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Clara Cell ◽  
Cell Protein ◽  
Preterm Neonates ◽  
Operating Characteristic Curve ◽  
Time Point

Objectives. To evaluate the predictive characteristics of KL-6 and CC16 for bronchopulmonary dysplasia (BPD) in preterm infants, either independently or in combination.Study Design. This prospective cohort study was performed from 2011 to 2013 with preterm neonates of gestational age ≤32 weeks and birth weight ≤1500 g. Serum KL-6 and CC16 levels were determined 7 and 14 days after birth.Results. Seventy-three preterm infants were studied. BPD was identified in 24 of these infants. After adjusting for potential confounders, serum KL-6 concentrations were found to be elevated in BPD infants at both time points relative to non-BPD infants, while serum CC16 concentrations were lower at 14 days. At both 7 d and 14 d of life the predictive power of KL-6 levels exceeded that of CC16 (area under receiver operating characteristic curve: at 7 d, 0.91 cf. 0.73,P=0.02; at 14 d, 0.95 cf. 0.85,P=0.05). The combination of these markers enhanced the sensitivity further.Conclusions. Serum KL-6 levels higher than 79.26 ng/mL at 14 days postpartum in preterm infants predict the occurrence of BPD. CC16 was less predictive than KL-6 at this time point, but KL-6 and CC16 together enhanced the prediction.

scholarly journals Impact of the definition of bronchopulmonary dysplasia on neurodevelopmental outcomes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yea-Seul Han ◽  
Sung-Ha Kim ◽  
Tae-Jung Sung
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Univariate Analysis ◽  
Admission Rate ◽  
Respiratory Disorder ◽  
Long Term Outcomes ◽  
Neurodevelopmental Outcomes ◽  
Predictive Values ◽  
Grade 3

AbstractUnderstanding the short and long-term pulmonary and neurologic outcomes of neonates with bronchopulmonary dysplasia (BPD) is important in neonatal care for low-birth-weight infants. Different criteria for BPD may have different associations with long-term outcomes. Currently, two criteria for diagnosing BPD have been proposed by the NIH (2001) and NRN (2019) for preterm infants at a postmenstrual age (PMA) of 36 weeks. We investigated which BPD definition best predicts long-term outcomes. Korean nationwide data for preterm infants born between 24+0 and < 32+0 weeks gestation from January 2013 to December 2015 were collected. For long-term outcomes, severity based on the NRN criteria was significantly related to neurodevelopmental impairment (NDI) in a univariate analysis after other risk factors were controlled. For the admission rate for respiratory disorder, grade 3 BPD of the NRN criteria had the highest specificity (96%), negative predictive value (86%), and accuracy (83%). For predicting NDI at the 18–24 month follow-up, grade 3 BPD of the NRN criteria had the best specificity (98%), positive (64%) and negative (79%) predictive values, and accuracy (78%) while NIH severe BPD had the highest sensitivity (60%). The NRN definition was more strongly associated with poor 2-year developmental outcomes. BPD diagnosed by NRN definitions might better identify infants at high risk for NDI.

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.

scholarly journals Influence of feeding artificial-formula milks containing docosahexaenoic and arachidonic acids on the postnatal long-chain polyunsaturated fatty acid status of healthy preterm infants

1996 ◽  
Vol 76 (5) ◽  
pp. 649-667 ◽  
Author(s):  
Magritha M. H. P. Foreman-Van Drongelen ◽  
Adriana C. Van Houwelingen ◽  
Arnold D. M. Kester ◽  
Carlos E. Blanco ◽  
Tom H. M. Hasaart ◽  
...  
Keyword(s):  
Fatty Acid ◽  
Human Milk ◽  
Preterm Infants ◽  
Venous Blood ◽  
Neurodevelopmental Outcome ◽  
Chain Polyunsaturated Fatty Acid ◽  
Formula Group ◽  
Acid Status ◽  
Arachidonic Acids ◽  
Long Chain

In view of the importance of long-chain polyunsaturated fatty acids (LCP) for growth and development of fetal and infant neural tissue, the influence of the dietary n-3 and n-6 LCP intake onthe LCP status of forty-three preterm infants (birth weight<1800 g) was studied. Thirty-one formula-fed infants were randomly assigned to receive a conventional formula lacking LCP (n 16), or an 22:6n-3-and 20:4n-6-enriched formula (n 15); twelve infants received their own mother's breast milk. Fatty acid compositions of plasma and erythrocyte (RBC) phospholipids (PL) were determined in umbilical venous blood, in weekly postnatal samples until day 35 of life and, for the formula-fed infants, at 3 months of corrected age. Both in plasma (P < 0·001) and RBC (P < 0.01) PLY, the changes with time until day 35 for 22: 6n-3 and 20:4n-6 in the two groups of formula-fed infants were significantly different, with higher values, comparable with those of human-milk-fed infants, in the LCP-enriched-formula group. At 3 months of corrected age, differences between the two formula-fed groups were even more pronounced. In conclusion, adding 22: 6n-3 and 20:4n-6 to artificial formulas in balanced ratios and in amounts similar to those found in preterm human milk raises both the 22:6n-3 and the 20:4n-6 status of formula-fed preterm infants to values found for human-milk-fed preterm infants. Additional studies are necessary to evaluate the potentially favourable effects of this combined addition on the neurodevelopmental outcome of preterm infants.

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