scholarly journals Impact of emollient therapy for preterm infants in the neonatal period on child neurodevelopment in Bangladesh: an observational cohort study

2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Gary L. Darmstadt ◽  
Naila Z. Khan ◽  
Summer Rosenstock ◽  
Humaira Muslima ◽  
Monowara Parveen ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Assessment Tool ◽  
Neonatal Period ◽  
Newborn Infants ◽  
Psychomotor Development ◽  
Fine Motor ◽  
Neurodevelopmental Outcomes ◽  
Link Type ◽  
Child Neurodevelopment

Abstract Background Topical treatment with sunflower seed oil (SSO) or Aquaphor® reduced sepsis and neonatal mortality in hospitalized preterm infants <33 weeks’ gestational age in Bangladesh. We sought to determine whether the emollient treatments improved neurodevelopmental outcomes during early childhood. Methods 497 infants were randomized to receive SSO, Aquaphor®, or neither through the neonatal period or hospital discharge. 159 infant survivors were enrolled in the longitudinal follow-up study using a validated Rapid Neurodevelopmental Assessment tool and the Bayley Scales of Infant Development II (BSID II) administered at three-monthly intervals for the first year and thereafter at six-monthly intervals. Lowess smoothing was used to display neurodevelopmental status across multiple domains by age and treatment group, and Generalized Estimating Equations (GEE) were used to compare treatment groups across age points. Results 123 children completed at least one follow-up visit. Lowess graphs suggest that lower proportions of children who received massage with either SSO or Aquaphor® had neurodevelopmental delays than control infants in a composite outcome of disabilities. In GEE analysis, infants receiving SSO showed a significant protective effect on the development of fine motor skills [odds ratio (OR) 0.92, 95% confidence interval (CI) 0.86–0.98, p=0.006]. The Psychomotor Development Index (PDI) in the BSID II showed significantly lower disability rates in the Aquaphor group (23.6%) compared to the control (55.2%) (OR 0.21, 95% CI 0.06–0.72, p=0.004). Conclusions Emollient massage of very preterm, hospitalized newborn infants improved some child neurodevelopmental outcomes over the first 2 years of follow-up. Findings warrant further confirmatory research. Trial registration ClinicalTrials.gov (98-04-21-03-2) under weblink https://clinicaltrials.gov/ct2/show/NCT00162747

scholarly journals Neurodevelopmental Assessment in Preterm Neonates at Early Ages: Screening of at-risk Infants for Long Term Sequlae

2017 ◽  
Vol 40 (1) ◽  
pp. 5-11
Author(s):  
Mirza Md Ziaul Islam ◽  
M Monir Hossain ◽  
Sheikh Anisul Haque ◽  
Naila Zaman Khan
Keyword(s):  
At Risk ◽  
Preterm Infants ◽  
Neonatal Period ◽  
Fine Motor ◽  
Preterm Neonates ◽  
Neurodevelopmental Outcomes ◽  
Cross Sectional ◽  
Gross Motor ◽  
Developmental Domains

Background: Preterm infants are at risk for long term neurodevelopmental impairements. Neurodevelopmental assessment at early months of infancy has been proposed as a valuable tool for prediction of neurodevelopmental outcomes in this population.Objective: The present study attempted to find the neurodevelopmental impairments in preterm infants and thus to identify the at risk infants for follow up and subsequent therapeutic intervention.Methodology: This prospective cross-sectional observational study was conducted in Dhaka Shishu (Children) Hospital from October 2011 to March, 2012. A total 103 preterm neonates who met the inclusion criteria underwent rapid neurodevelopmental assessment (RNDA) at neonatal period and again at their 3 months of age to find the at risk infants for long term neurodevelopmental impairments.Results: Among the enrolled 103 preterm infants during RNDA at neonatal period, abnormal domains found in primitive reflexes 41(39.7%), gross motor 42(40.7%), fine motor 32(31%), vision 40(38.7%), hearing 32 (31%), speech 40(38.7%), cognition 3(2.8%), behavior 3 (2.8%) and 3(2.8%) had seizure. Again in RNDA at 3 months of age, the no. of preterm infants having abnormal developmental domains are: gross motor 49(47.5%), fine motor 19(18.3), vision 9(8.6%), hearing 16(15.4%), speech 15 (14.5%), cognition 6(5.7%), speech 15 (14.5%), cognition 6(5.7%), behavior 11(10.6%) and 3 (2.9%) had seizure.Conclusion: The identification of neurodevelopmental impairments in early months of preterm infants should offer a valuable complement to tools for identification of at risk infants for long term sequlae (in neurodevelopmental impairment).Bangladesh J Child Health 2016; VOL 40 (1) :5-11

scholarly journals Neurodevelopmental Outcomes at 18 Months of Corrected Age for Late Preterm Infants Born at 34 and 35 Gestational Weeks

2021 ◽  
Vol 18 (2) ◽  
pp. 640 ◽  
Author(s):  
Ruka Nakasone ◽  
Kazumichi Fujioka ◽  
Yuki Kyono ◽  
Asumi Yoshida ◽  
Takumi Kido ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Late Preterm ◽  
Psychomotor Development ◽  
Youden Index ◽  
Chromosomal Anomalies ◽  
Clinical Factors ◽  
Neurodevelopmental Outcomes ◽  
Late Preterm Infants ◽  
Significant Difference ◽  
Severe Hyperbilirubinemia

To date, the difference in neurodevelopmental outcomes between late preterm infants (LPI) born at 34 and 35 gestational weeks (LPI-34 and LPI-35, respectively) has not been elucidated. This retrospective study aimed to evaluate neurodevelopmental outcomes at 18 months of corrected age for LPI-34 and LPI-35, and to elucidate factors predicting neurodevelopmental impairment (NDI). Records of all LPI-34 (n = 93) and LPI-35 (n = 121) admitted to our facility from 2013 to 2017 were reviewed. Patients with congenital or chromosomal anomalies, severe neonatal asphyxia, and without developmental quotient (DQ) data were excluded. Psychomotor development was assessed as a DQ using the Kyoto Scale of Psychological Development at 18 months of corrected age. NDI was defined as DQ < 80 or when severe neurodevelopmental problems made neurodevelopmental assessment impossible. We compared the clinical characteristics and DQ values between LPI-34 (n = 62) and LPI-35 (n = 73). To elucidate the factors predicting NDI at 18 months of corrected age, we compared clinical factors between the NDI (n = 17) and non-NDI (n = 118) groups. No significant difference was observed in DQ values at 18 months of corrected age between the groups in each area and overall. Among clinical factors, male sex, intraventricular hemorrhage (IVH), hyperbilirubinemia, and severe hyperbilirubinemia had a higher prevalence in the NDI group than in the non-NDI group, and IVH and/or severe hyperbilirubinemia showed the highest Youden Index values for predicting NDI. Based on the results of this study, we can conclude that no significant difference in neurodevelopmental outcomes at 18 months of corrected age was observed between LPI-34 and LPI-35. Patients with severe hyperbilirubinemia and/or IVH should be considered to be at high risk for developing NDI.

scholarly journals Prevalence and associated factors of neurodevelopmental disability among infants in eastern Uganda: a population based study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Gertrude Namazzi ◽  
Helena Hildenwall ◽  
Paul Mubiri ◽  
Claudia Hanson ◽  
Christine Nalwadda ◽  
...  
Keyword(s):  
Low Income ◽  
Social Behaviour ◽  
Assessment Tool ◽  
Statistical Significance ◽  
Low Income Countries ◽  
Fine Motor ◽  
Neurodevelopmental Outcomes ◽  
Factors Associated ◽  
Neurodevelopmental Disability ◽  
Eastern Uganda

Abstract Background Neurodevelopmental disability (NDD) is increasingly acknowledged as one of the important causes of disease burden in low income countries. None the less, there is a dearth of data on the burden of NDD and its determinants in these settings. We aimed to establish the prevalence and factors associated with NDD among infants in Eastern Uganda. Methods We assessed 487 infants aged 9–12 months within Iganga-Mayuge Health Demographic Surveillance Site in Eastern Uganda using the Malawi Developmental Assessment Tool. The tool has four domains: gross motor, fine motor, language and social domains. An infant failed a domain if she/he failed more than two parameters of the expected at his/her age. We interviewed mothers on factors that could influence the infants’ neurodevelopmental outcomes. Data were analysed using STATA version 14. We used odds ratios and 95% confidence intervals to assess statistical significance of associations. Results Of the 487 infants, 62(12.7%) had an NDD in at least one of the domains. The most affected was social behaviour where 52(10.7%) infants had an NDD. Severe impairment was seen among 9(1.8%) infants with NDD in either three or four domains. Factors associated with NDD at multivariate logistic regression included: parity of more than three children (aOR = 1.8, 95% CI: 1.02–3.18); failure to cry at birth (aOR = 3.6, 95% CI: 1.46–9.17) and post-neonatal complications (aOR = 4.15, 95% CI: 1.22–14.10). Low birth weight, immediate and exclusive breast feeding were not significantly associated with NDD. Conclusion We found a high NDD burden among infants particularly in the social behaviour domain. To optimise the socio-neural development of infants, programs are needed to educate and work with families on how to engage and stimulate infants. Existing immunisation clinics and community health worker strategies provide an excellent opportunity for stemming this burden.

scholarly journals Early Intervention in preterm infants modulates LINE-1 promoter methylation and neurodevelopment

2019 ◽  
Author(s):  
Camilla Fontana ◽  
Federica Marasca ◽  
Livia Provitera ◽  
Sara Mancinelli ◽  
Nicola Pesenti ◽  
...  
Keyword(s):  
Early Intervention ◽  
Preterm Infants ◽  
Mouse Brain ◽  
Maternal Care ◽  
Early Life ◽  
Copy Number Variations ◽  
Postnatal Life ◽  
Neurodevelopmental Outcomes ◽  
Term Infants ◽  
Link Type

ABSTRACTBackgroundEarly life adversity exposure impacts preterm infants’ neurodevelopment and early intervention protocols may modulate neurodevelopmental outcomes.Neuronal genomes are plastic in response to environment and mobile genetic elements, including LINE-1 (L1), are source of brain genomic mosaicism. Maternal care during early life regulates L1 methylation and copy number variations (CNVs) in mice. Here, we sought to identify the effects of maternal care and positive multisensory stimulation (Early Intervention) on L1 methylation and neurodevelopment in preterm infants.MethodsVery preterm infants were randomized to receive Standard Care or Early Intervention. L1 methylation was measured at birth and at hospital discharge. At 12 months infants’ neurodevelopment was evaluated with the Griffiths Scales. L1 methylation and CNVs were measured in mouse brain areas at embryonic and postnatal stages.ResultsWe demonstrated that L1 is hypomethylated in preterm versus term infants at birth. Early Intervention contributes to restore L1 methylation and positively modulates neurodevelopment. We showed that L1 methylation is developmentally-regulated in mice, decreasing in early postnatal life stages, which turns into an increased L1 CNVs specifically in hippocampus and cortex.ConclusionsHere we demonstrated that L1 dynamics can be modulated by Early Intervention, in parallel with ameliorated neurodevelopmental outcomes. We further identified a specific developmental window of the fetal mouse brain, sensitive to early life experience, in which L1 dynamics are fine-tuned contributing to shape the brain genomic landscape.Trail RegistrationclinicalTrial.gov (NCT02983513)FundingItalian Ministry of Health (RC 780/03 2017), University of Milan (DISCCO 2015) and INGM internal funding.

"COMPARATIVE STUDY OF EARLY NEONATAL MORBIDITIES OF LATE PRETERM AND TERM NEONATES"

2021 ◽  
pp. 23-25
Author(s):  
Jatin Manocha ◽  
Kusum Mahajan ◽  
Anuj Kumar
Keyword(s):  
Preterm Infants ◽  
Prospective Observational Study ◽  
Neonatal Period ◽  
Newborn Infants ◽  
Late Preterm ◽  
Preterm Neonates ◽  
Feeding Problems ◽  
Term Neonates ◽  
Late Preterm Infants ◽  
Study Results

Background- Newborn infants are unique in their physiology and the health problems that they experience. Neonatal period is dened from birth to under four weeks of age. Late preterm infants may physiologically and physically appear like infants born at term, but most late preterm infants may undergo complications like respiratory distress, apnea, hypothermia, feeding problems, hypoglycemia, hyperbilirubinemia, sepsis, and mortality. AIM-To compare the clinical prole of late preterm neonates with term neonates. MATERIALAND METHODS: This prospective observational study was carried out in neonatal division of department of pediatrics MMIMSR, Mullana. Eligible neonates delivered at MMIMSR, Mullana born from 34 weeks up to 42 weeks gestation were included. All infants enrolled in the study was followed daily till rst 7 days of life for any morbidity by clinical evaluation and review of hospital records.104 preterms included in the study and 226 term neonates were included in the study. Results- Preterms born via LSCS and NVD were(58%vs.42%).Morbidities in late preterms were Hypoglycemia (21.2% vs. 9.3%), Hypothermia (15.4%vs5.7%), hypocalcaemia (38.4% vs. 5.3%), neonatal hyperbilirubinemia(67.3% vs. 30.5%), feeding difculties(44.2% vs. 14.6%), sepsis(40.4% vs. 19.5%), respiratory support(53% vs. 47%)

Neurodevelopmental Outcome during the First Year of Life in Preterm Infants after Supplementation of a Prebiotic Mixture in the Neonatal Period: A Follow-Up Study

2013 ◽  
Vol 45 (01) ◽  
pp. 022-029 ◽  
Author(s):  
Natalie LeCouffe ◽  
Elisabeth Westerbeek ◽  
Petra van Schie ◽  
Veronique Schaaf ◽  
Harrie Lafeber ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Period ◽  
Neurodevelopmental Outcome ◽  
First Year ◽  
Follow Up Study ◽  
First Year Of Life

Delayed Achievement of Oral Feedings Is Associated with Adverse Neurodevelopmental Outcomes at 18 to 26 Months Follow-up in Preterm Infants

2019 ◽  
Vol 37 (05) ◽  
pp. 483-490 ◽  
Author(s):  
Shabnam Lainwala ◽  
Natalia Kosyakova ◽  
Kimberly Power ◽  
Naveed Hussain ◽  
James E. Moore ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Retrospective Study ◽  
Preterm Infants ◽  
Neurodevelopmental Outcome ◽  
Oral Intake ◽  
Neurodevelopmental Outcomes ◽  
Motor Delay ◽  
Postmenstrual Age ◽  
Multivariable Analyses

Abstract Objective This study aimed to compare neurodevelopmental outcomes in preterm infants at 18 to 26 months corrected age (CA) who did versus did not achieve full oral feedings at 40 weeks postmenstrual age (PMA). Study Design This retrospective study included infants born between 2010 and 2015 with gestational age <32 weeks and followed between 18 and 26 months CA. Achievement of full oral feedings was defined as oral intake >130 mL/kg/d for >72 hours by 40 weeks PMA. Incidence of cognitive, language, or motor delay, or cerebral palsy at 18 to 26 months CA was compared in multivariable analyses for infants in the two feeding groups. Results Of 372 included infants, those achieving full oral feedings had lower incidence of any adverse neurodevelopmental outcome (p < 0.001) compared with those who did not achieve full oral feedings. In multivariable analyses, achievement of full oral feedings by 40 weeks PMA was associated with decreased odds of cognitive, language, and motor delays, cerebral palsy, and any adverse neurodevelopmental outcome at follow-up. Conclusion Achievement of full oral feedings by 40 weeks PMA was associated with better adjusted neurodevelopmental outcomes at 18 to 26 months CA. Inability to fully feed orally at 40 weeks PMA may be a simple, clinically useful marker for risk of adverse neurodevelopmental outcomes.

Neurodevelopmental Outcomes of Preterm Infants Treated with Oral Paracetamol Versus Ibuprofen for Patent Ductus Arteriosus

2017 ◽  
Vol 34 (12) ◽  
pp. 1185-1189 ◽  
Author(s):  
Zeynep Eras ◽  
Nurdan Uras ◽  
Fuat Canpolat ◽  
Omer Erdeve ◽  
Serife Oguz ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Infant Development ◽  
Controlled Trial ◽  
Ductus Arteriosus ◽  
Neurodevelopmental Outcomes ◽  
Significant Difference ◽  
Oral Ibuprofen ◽  
Patent Ductus

Objective This study aims to determine the effects of paracetamol versus ibuprofen treatment given to preterm infants for the pharmacological closure of patent ductus arteriosus (PDA) on neurodevelopmental outcomes at 18 to 24 months' corrected age. Method A follow-up study was conducted to evaluate the neurodevelopmental outcomes of preterm infants (gestational age ≤ 30 weeks) enrolled in a randomized controlled trial comparing oral paracetamol versus oral ibuprofen for the closure of PDA. The developmental assessment was done by using “Bayley Scales of Infant Development, Second Edition” at 18 to 24 months' corrected age. Results A total of 80 infants completed the trial protocol. Of the 75 infants eligible for follow-up, 61 infants (30 in the paracetamol group and 31 in the ibuprofen group) were evaluated. There was no significant difference in neurodevelopmental outcomes between the two groups. Conclusion The neurodevelopmental outcomes did not differ among the preterm infants who receive either paracetamol or ibuprofen at 18 to 24 months' corrected age.

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.

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