Tracheotomy in the Preterm Infant

Over the last decade, prolonged survival of preterm infants (gestation ≤ 36 weeks) who require lengthy periods of mechanical ventilation has necessitated that many of these infants undergo tracheotomy. The complication rate for tracheotomy in these preterm infants has not been reported. We compared 83 full-term (FT) infants who underwent tracheotomy in their first year of life with 41 preterm infants. Twenty-three preterm infants had birth weight ≥ 1,500 g (PT), and 18 of the preterm infants had gestational age ≤32 weeks and birth weight ≤ 1,500 g (PT-VLBW). Early complications (day 0 to 7) occurred in over 50% of the PT-VLBW compared to only 24% of the FT infants. Late complication rates were similar for all three groups. This higher early complication rate for PT-VLBW infants may be related to gestational age, low birth weight, and medical condition rather than surgical technique.

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Neurodevelopmental outcome in infants with esophageal atresia: risk factors in the first year of life

Diseases of the Esophagus ◽

10.1093/dote/doaa102 ◽

2020 ◽

Author(s):

Bevilacqua Francesca ◽

Ragni Benedetta ◽

Conforti Andrea ◽

Braguglia Annabella ◽

Gentile Simonetta ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Cognitive Development ◽

Low Birth Weight ◽

Multiple Regression ◽

Esophageal Atresia ◽

Gestational Age ◽

Motor Development ◽

First Year ◽

First Year Of Life

Summary Data on neurodevelopmental outcomes of infants born with esophageal atresia (EA) are still scarce and controversial. The aims of our study were to evaluate motor and cognitive development during the first year of life, in patients operated on of EA and to investigate potential risk factors for motor and cognitive development both at 6 and 12 months. This is an observational prospective longitudinal study in a selected cohort of type C and D EA infants enrolled in our follow-up program from 2009 to 2017. In order to exclude possible confounding factors, the following exclusion criteria were applied: (i) gestational age ≤ 32 weeks and/or birth weight ≤ 1500 g; (ii) genetic syndrome or chromosomal anomaly known to be associated with neurodevelopmental delay; (iii) neurologic disease; (iv) esophageal gap ≥three vertebral bodies. Patients were evaluated at 6 and 12 months of life (corrected age for infants with a gestational age of 32–37 weeks) with the Bayley Scales of Infant and Toddler Development—3rd Edition. In our selected cohort of EA infants, 82 were evaluated at 6 months and 59 were reevaluated at 12 months. Both Motor and Cognitive average scores were within the norm at both time points. However, we report increased number of infants with motor delay with time: 14% at 6 months and 24% at 12 months. Multiple regression analysis for Motor scores at 6 [F(4,74) = 4.363, P = 0.003] and 12 months [F(6,50) = 2.634, P = 0.027] identified (i) low birth weight, (ii) longer hospital stay and (iii) weight < fifth percentile at 1 year as risk factors. Interestingly, average Cognitive scores also increased with time from 85.2% at 6 months and 96.6% at 12 months. Multiple regression models explaining variance of Cognitive scores at 6 [F(4, 73) = 2.458, P = 0.053] and 12 months [F(6, 49) = 1.232, P = 0.306] were nonsignificant. Our selected cohort of EA patients shows, on the average, Motor and Cognitive scores within the norm both at 6 and 12 months. Nevertheless, the percentage of infants with Motor scores below the average increases regardless gestational age. None of clinical and sociodemographic variables taken into consideration was able to predict cognitive development both at 6 and 12 months whereas risk factors for Motor development change during the first year of life. Healthcare providers should pay particular attention to patients with low birth weight, longer hospital stays and weight under fifth percentile at 1 year. Future studies should include long-term outcomes to reveal possible catch up in motor development and/or possible findings in Cognitive scores.

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CHARACTERISTICS OF THE METABOLIC STATUS OF CHILDREN OF THE FIRST YEAR OF LIFE WITH PROTEIN-ENERGY DEFICIENCY DEPENDING ON THE GESTATIONAL AGE AT BIRTH

Russian Clinical Laboratory Diagnostics ◽

10.18821/0869-2084-2020-65-7-405-410 ◽

2020 ◽

Vol 65 (7) ◽

pp. 405-410

Author(s):

I. V. Gorbacheva ◽

O. U. Kuznetsova ◽

F. N. Gilmiyarova ◽

D. V. Pechkurov ◽

L. N. Vinogradova

Keyword(s):

Preterm Infants ◽

Gestational Age ◽

Protein Energy Malnutrition ◽

Transferrin Saturation ◽

Deficiency Anemia ◽

First Year ◽

Content Increase ◽

Term Infants ◽

Protein Energy ◽

First Year Of Life

Comparative analysis of energy-plastic exchange indicators in mature and premature children of the first year of life in the development of protein-energy malnutrition (PEM) was carried out. Unidirectional changes are revealed, including an increase in creatinine, lactate and creatine phosphokinase activity levels, suggesting a n increasing muscle mass deficit against the background of glucose anaerobic oxidation activation. In preterm infants, glucose and triacylglicerine levels decrease, which reflects uncompensated insufficiency of energy substrates and, accordingly, ATP level. Multidirectional deviations in metabolism are pyruvate and ATP content: increase in full-term infants and decrease in preterm infants, that should be taken into account when monitoring condition of children with PEM. A significant decrease of pyruvic acid in preterm infants against the background of the levels of total protein, albumin, hemoglobin, and transferrin, not exceeding reference values, can obviously testify to the active use of this integral metabolite to maintain the fund of substituted amino acids. Development of this pathology in both mature and premature infants creates a pre-morbid background for iron deficiency anemia-diagnostic panel, which should be supplemented by calculation of transferrin saturation coefficient. Regardless of gestational age in childbirth during the formation of PEM, the lipid spectrum is rearranged according to atherogenic type: at normal values of total cholesterol, there is a significant increase in low and very low density lipoproteins with an increase in the atherogenicity coefficient. This singles out children with the pathology in question as a risk group for the development of the atherosclerotic process later, which justifies the recommendation to control the lipid profile in children of the first year of life.

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Elevated Levels of Fetal Hemoglobin Synthesis in Infants With Bronchopulmonary Dysplasia

PEDIATRICS ◽

10.1542/peds.86.2.193 ◽

1990 ◽

Vol 86 (2) ◽

pp. 193-196

Author(s):

Harry Bard ◽

Janie Prosmanne

Keyword(s):

Birth Weight ◽

Bronchopulmonary Dysplasia ◽

Gestational Age ◽

Fetal Hemoglobin ◽

Amino Acid Mixture ◽

Acid Mixture ◽

First Year ◽

Postconceptional Age ◽

The Mean ◽

First Year Of Life

A study was devised to determine whether levels of fetal hemoglobin (HbF) synthesis are elevated in infants with bronchopulmonary dysplasia (BPD) when compared with the levels of HbF synthesis found in normal control infants. Twelve infants with BPD, whose postconceptional ages ranged from 40 to 62 weeks, were studied. The mean (±SD) gestational age and birth weight was 29 ± 1.9 weeks and 1289 ± 376 g, respectively. Elevation infants matched for birth weight, gestational age, and postnatal age served as the control subjects. Blood samples were incubated in an amino acid mixture containing [14C]leucine. The adult hemoglobin and HbF were then separated by column chromatography on diethylaminoethyl-Sephadex. The results demonstrated that the mean (±SD) level of HbF synthesis in infants with BPD was significantly higher than that in the control infants (42.6 ± 22.9% vs 18.8 ± 12.8%; P < .01). When levels of HbF synthesis in the infants with BPD and the control infants were compared with data previously reported in normal infants, 7 of the 12 infants with BPD, but none of the control infants, were synthesizing amounts of HbF greater than would be expected for their postconceptional age. The results suggest that cardiopulmonary insufficiency could stimulate HbF synthesis during the first year of life as a result of an erythropoietic response to hypoxemia.

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The Relationship of Early Behaviour to Later Developmental Outcome for Preterm Children

International Journal of Behavioral Development ◽

10.1177/016502549601900304 ◽

1996 ◽

Vol 19 (3) ◽

pp. 517-532 ◽

Cited By ~ 1

Author(s):

Jaroslava Dittrichová ◽

Václav Břicháček ◽

František Mandys ◽

Karel Paul ◽

Daniela Sobotková ◽

...

Keyword(s):

Social Environment ◽

Preterm Infants ◽

Gestational Age ◽

Early Identification ◽

Developmental Outcomes ◽

First Year ◽

The Social ◽

First Year Of Life ◽

Relationship Of ◽

The Relationship

The present study aimed, first, to analyse in detail early sleep states in 21 preterm infants born before the 33rd week of gestational age and compare them with sleep states in 23 fullterm infants assessed at gestationally matched ages in the first six months. Second, to determine whether analyses of early sleep states in preterm infants may enable identification of infants with future developmental disabilities. In addition to evaluations of perinatal risk factors, neurological condition, psychological development, and social environment during the first year of life, examinations of psychological and neurological development and the assessment of the social environment at 3 and 9 years were carried out. Measures of perinatal status and sleep states up to the age of 40 weeks gestational age did not correlate with outcome measures at 3 and 9 years. However, the polygraphic measures of sleep states at 12 and 24 weeks corrected age, predicted the 3-year developmental outcomes. The complexity of these measures may contribute to their predictive validity for the outcomes at 3 years. Measures of the social environment at 3 and 9 years contributed significantly to the prediction of 9-year developmental outcomes. These results indicate that environmental factors may become more important with age. The detailed analysis of early sleep patterns may enable the early identification of infants who need special care and intervention.

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The premature small-for-gestational-age infant during the first year of life: Comparison by birth weight and gestational age

The Journal of Pediatrics ◽

10.1016/s0022-3476(88)80584-5 ◽

1988 ◽

Vol 113 (6) ◽

pp. 1066-1073 ◽

Cited By ~ 58

Author(s):

Ivette C. Pena ◽

Annabel J. Teberg ◽

Karen M. Finello

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Small For Gestational Age ◽

First Year ◽

First Year Of Life

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First-year growth of 834 preterm infants in a Chinese population: a single-center study

BMC Pediatrics ◽

10.1186/s12887-019-1752-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Ying Deng ◽

Fan Yang ◽

Dezhi Mu

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

First Year ◽

Poor Growth ◽

Vlbw Infants ◽

Catch Up ◽

First Year Of Life ◽

Prevalence Of Anemia

Abstract Background The aim of this study was to follow the growth and hematological indicators of preterm infants during their first year. Methods Neonates below 37 gestational weeks had routine follow-ups up through 1 year from January 2012 to December 2015 at West China 2nd University Hospital, Sichuan University. Weight, length and head circumference (HC) were measured monthly during the first 6 months, followed by monitoring every second month until 12 months. The catch-up growth defined as a gain of Z-score > 0.67 according to previous study. All preterm infants were prescribed iron prophylaxis based on national guideline. The hemoglobin concentration was examined at 6 and 12 months. Results Altogether, 132 very-low-birth-weight (VLBW), 504 low-birth-weight (LBW) and 198 normal-birth-weight (NBW) infants were followed. The rates of catch-up growth for weight, length and HC 12 months of corrected age (CA) were 22.6, 29.1 and 14.6%, respectively. SGA and VLBW infants showed higher catch-up growth rates. The overall prevalence of anemia was 6.8% at 6 months and 7.8% at 12 months. The Z-scores for weight-for-length, length and HC were lower in the VLBW and SGA preterm infant groups than in the other preterm groups throughout the first year of life. The incidences of stunting, microcephaly and wasting changed from 5, 1.3 and 3.7% to 2, 1.1, 0.9 and 2.4%, respectively, during the first year. However, the incidences of wasting and stunting were higher for the VLBW infants than for the LBW and NBW infants at 12 months (9.3% vs. 1.4%, p < 0.01; 9.3% vs. 1%, p < 0.01,respectively; 4.7% vs. 0.8%, p < 0.01, 4.7% vs. 0%, p < 0.01,respectively). Similar results were observed between SGA and AGA infants (8.7% vs. 1.5%, p < 0.01; 5.8% vs. 0.4%, p < 0.01). Logistic regression revealed SGA and VLBW as risk factors for poor growth (WLZ < -2SD) at 12 months (OR = 5.5, 95% CI: 2.1–14.8, p < 0.01: OR = 4.8, 95% CI: 1.8–12.8, p < 0.01, respectively). Conclusion The VLBW and SGA preterm infants showed significant catch-up growth during their first year of life. However, SGA and VLBW were risk factors for poor growth during the preterm infants’ first year of life. Prophylactic iron supplementation in preterm infants appears to reduce the prevalence of anemia.

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Developmental trajectories of motor function in term infants and very-low-birth-weight preterm infants during the first year of life

Physiotherapy ◽

10.1016/j.physio.2015.03.1415 ◽

2015 ◽

Vol 101 ◽

pp. e1451

Author(s):

Y.H. Su ◽

L.C. Chen ◽

Y.T. Wu ◽

W.S. Hsieh ◽

C.H. Hsu ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Motor Function ◽

Very Low Birth Weight ◽

Developmental Trajectories ◽

First Year ◽

Term Infants ◽

First Year Of Life

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Systematic review of the healthcare cost of bronchopulmonary dysplasia

BMJ Open ◽

10.1136/bmjopen-2020-045729 ◽

2021 ◽

Vol 11 (8) ◽

pp. e045729

Author(s):

Jhangir Humayun ◽

Chatarina Löfqvist ◽

David Ley ◽

Ann Hellström ◽

Hanna Gyllensten

Keyword(s):

Systematic Review ◽

Quality Assessment ◽

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Gestational Age ◽

First Year ◽

Long Term Follow Up ◽

First Year Of Life

ObjectivesTo determine the costs directly or indirectly related to bronchopulmonary dysplasia (BPD) in preterm infants. The secondary objective was to stratify the costs based on gestational age and/or birth weight.DesignSystematic literature review.SettingPubMed and Scopus were searched on 3 February 2020. Studies were selected based on eligibility criteria by two independent reviewers. Included studies were further searched to identify eligible references and citations.Two independent reviewers extracted data with a prespecified data extraction sheet, including items from a published checklist for quality assessment. The costs in the included studies are reported descriptively.Primary outcome measureCosts of BPD.ResultsThe 13 included studies reported the total costs or marginal costs of BPD. Most studies reported costs during birth hospitalisation (cost range: Int$21 392–Int$1 094 509 per child, equivalent to €19 103–€977 397, in 2019) and/or during the first year of life. One study reported costs during the first 2 years; two other studies reported costs later, during the preschool period and one study included a long-term follow-up. The highest mean costs were associated with infants born at extremely low gestational ages. The quality assessment indicated a low risk of bias in the reported findings of included studies.ConclusionsThis study was the first systematic review of costs associated with BPD. We confirmed previous reports of high costs and described the long-term follow-up necessary for preterm infants with BPD, particularly infants of very low gestational age. Moreover, we identified a need for studies that estimate costs outside hospitals and after the first year of life.PROSPERO registration numberCRD42020173234.

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