scholarly journals Follow-Up Examination at the Age of 15 Months of Extremely Preterm Infants after Postnatal Estradiol and Progesterone Replacement

2001 ◽  
Vol 86 (2) ◽  
pp. 601-603 ◽  
Author(s):  
Andreas Trotter ◽  
Birgit Bokelmann ◽  
Wolfgang Sorgo ◽  
Doris Bechinger-Kornhuber ◽  
Hilde Heinemann ◽  
...  
Keyword(s):  
Pilot Study ◽  
Preterm Infants ◽  
Bone Mineralization ◽  
Psychomotor Development ◽  
Control Group ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Developmental Index ◽  
The Impact

A randomized controlled pilot study was performed with a sample of extremely preterm infants to evaluate the impact of postnatal estradiol and progesterone replacement on postnatal bone mineral accretion. Twenty-five of 30 infants in the pilot study survived, and of these, 24 infants were available for the follow-up examination at a median chronological age of 18.1 months (minimum-maximum, 17.0–20.6) corresponding to a corrected age of 14.8 months (minimum-maximum, 12.9–17.4). Somatic growth data and bone mineralization showed no differences between the hormone-treated and control group infants. The deviation of the skeletal age from the corrected age was 0.0 months (minimum-maximum, −7.7 to 7.4) for hormone-treated infants compared with −1.7 months (minimum-maximum, −7.5 to 5.9) for the control group. The Bayley scales mental and psychomotor developmental indexes were 89 (minimum-maximum, 71–107) and 101 (minimum-maximum, 49–121) for the hormone-treated infants and 93 (minimum-maximum, 49–111) and 71 (minimum-maximum, 49–121) for the control group infants, respectively (mental developmental index, P = 1.0; psychomotor developmental index, P = 0.14). The normal psychomotor development in the hormone-treated infants compared with the below average development in the control group infants is encouraging and indicates the potentially important integrative role of sex steroids for the developing brain. Larger studies on the effects of the postnatal replacement of estradiol and progesterone in extremely preterm infants are warranted.

scholarly journals Long-Term Outcome after Asphyxia and Therapeutic Hypothermia in Late Preterm Infants: A Pilot Study

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 994
Author(s):  
Hanne Lademann ◽  
Karl Abshagen ◽  
Anna Janning ◽  
Jan Däbritz ◽  
Dirk Olbertz
Keyword(s):  
Pilot Study ◽  
Preterm Infants ◽  
Perinatal Asphyxia ◽  
Psychomotor Development ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Developmental Index ◽  
Mental Developmental Index

Therapeutic hypothermia (THT) is the recommended treatment for neuroprotection in (near) term newborns that experience perinatal asphyxia with hypoxic-ischemic encephalopathy. The benefit of THT in preterm newborns is unknown. This pilot study aims to investigate long-term outcomes of late preterm asphyctic infants with and without THT compared to term infants. The single-center, retrospective analysis examined medical charts of infants with perinatal asphyxia born between 2008 and 2015. Long-term outcome was assessed using the Bayley Scales of Infant Development 2 at the age of (corrected) 24 months. Term (n = 31) and preterm (n = 8) infants with THT showed no differences regarding their long-term outcomes of psychomotor development (Psychomotor Developmental Index 101 ± 16 vs. 105 ± 11, p = 0.570), whereas preterm infants had a better mental outcome (Mental Developmental Index 105 ± 13 vs. 93 ± 18, p = 0.048). Preterm infants with and without (n = 69) THT showed a similar mental and psychomotor development (Mental Developmental Index 105 ± 13 vs. 96 ± 20, p = 0.527; Psychomotor Developmental Index 105 ± 11 vs. 105 ± 15, p = 0.927). The study highlights the importance of studying THT in asphyctic preterm infants. However, this study shows limitations and should not be used as a basis for decision-making in the clinical context. Results of a multicenter trial of THT for preterm infants (ID No.: CN-01540535) have to be awaited.

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

Aerosolized Iloprost in the Treatment of Pulmonary Hypertension in Extremely Preterm Infants: A Pilot Study

2008 ◽  
Vol 220 (2) ◽  
pp. 66-69 ◽  
Author(s):  
F. Eifinger ◽  
N. Sreeram ◽  
K. Mehler ◽  
C. Huenseler ◽  
A. Kribs ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pilot Study ◽  
Preterm Infants ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Persistent pulmonary hypertension of the newborn in extremely preterm infants: a Japanese cohort study

2018 ◽  
Vol 103 (6) ◽  
pp. F554-F561 ◽  
Author(s):  
Hidehiko Nakanishi ◽  
Hideyo Suenaga ◽  
Atsushi Uchiyama ◽  
Satoshi Kusuda
Keyword(s):  
Pulmonary Hypertension ◽  
Cohort Study ◽  
Preterm Infants ◽  
Research Network ◽  
Persistent Pulmonary Hypertension ◽  
Neurodevelopmental Outcomes ◽  
Significant Independent Risk Factor ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
The Impact

ObjectiveTo investigate the characteristics of persistent pulmonary hypertension of the newborn (PPHN) in extremely preterm infants and its impact on neurodevelopmental outcomes at 3 years of age.DesignA retrospective multicentre cohort study.Settings202 tertiary perinatal centres registered in the Neonatal Research Network of Japan (NRNJ).PatientsInfants born at <28 weeks of gestational age (GA), between 2003 and 2012, were extracted from tertiary perinatal centres participating in NRNJ.Main outcome measuresDemographic characteristics, morbidity, interventions and mortality were compared for infants with and without PPHN. Multivariable logistic analysis was performed to evaluate the impact of PPHN on long-term neurodevelopmental outcomes (the prevalence rate of cerebral palsy, need for home oxygen therapy, and visual, hearing and cognitive impairment) at 3 years of age.ResultsThe prevalence of PPHN among the 12 954 extremely preterm infants enrolled was 8.1% (95% CI 7.7% to 8.6%), with the trend increasing annually, and a higher proportion as GA decreased: 18.5% (range, 15.2% to 22.4%) for infants born at 22 weeks compared with 4.4% (range, 3.8% to 5.2%) for those born at 27 weeks. Clinical chorioamnionitis and premature rupture of membranes were associated with PPHN. On multivariate analysis of the data from 5923 infants followed up for 3 years, PPHN was a significant independent risk factor for visual impairment (adjusted OR, 1.42, 95% CI 1.03 to 1.97).ConclusionsThe prevalence of PPHN in extremely preterm infants has been increasing over the past decade in Japan. Clinicians should be aware of visual impairments as a neurodevelopmental abnormality among infants with PPHN.

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 Use of Intranasal Insulin as Neuroprotection From Hyperglycemia in Rat Model of Extremely Preterm Infants

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A444-A444
Author(s):  
Lauren McClure Yauch ◽  
Kathleen Ennis ◽  
Ivan Tkac ◽  
Raghavendra Rao
Keyword(s):  
Preterm Infants ◽  
Neuronal Activity ◽  
Rat Model ◽  
Control Group ◽  
Intranasal Insulin ◽  
Long Term Effects ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Neurochemical Profile

Abstract Background: Hyperglycemia is common in extremely preterm infants (EPI) and is a risk factor for increased mortality and morbidity, including abnormal neurodevelopment. Hippocampus-mediated cognitive deficits are common in this population. In a rat model of insulinopenic hyperglycemia, abnormal neurochemistry in the hippocampus was found, with lactate, glutamate (Glu):glutamine (Gln) ratio lower and Phosphorylated Creatinine (PCr):Creatinine (Cr) higher. Intranasal insulin has been shown to improve cognitive function in animal models of Alzheimer’s disease and type 2 diabetes mellitus, as well as in adult human studies of Alzheimer’s disease. No study has previous investigated the use of intranasal insulin on preventing the long-term effects of hyperglycemia in the EPI population. Objective: To determine whether administration of intranasal insulin during early postnatal days would negate the effects of hyperglycemia on the developing hippocampus in neonatal rat model of streptozotocin (STZ)-induced hyperglycemia. Design/Methods: STZ (80mg/kg IP) was injected on postnatal day (P) 2, and littermates in the control group were injected with an equivalent volume of citrate buffer. STZ pups were randomized to intranasal insulin, 3U twice daily from P3-P6 (STZ + INS) or left untreated (STZ). Neurochemical profile (consisting of 20 metabolites, PCr:Cr and Glu:Gln ratios) of the hippocampus was evaluated using ultra-high-field (9.4 T) magnetic resonance spectroscopy (MRS) on P7 (acute effects) and P56 (long-term effects) compared with the control group (CON)(N=6/group). Results: Mean glucose values from P3-P6 were higher in STZ groups (STZ = 279.0 +/- 132.2 mg/dL, STZ+INS = 274.4 +/- 89.5 mg/dL, CONT = 128.4 +/- 15.1 mg/dL). The neurochemical profile was different at both P7 and P56. On P7, compared with the control, the taurine (Tau) was higher in the STZ groups (p = 0.007. At P56, PCr:Cr was higher in the STZ group compared to CONT and STZ+INS groups (p = 0.04). No difference noted between the STZ+INS and CONT groups. No other metabolites were altered. Conclusion: Neonatal hyperglycemia alters the acute and long-term neurochemical profile in the hippocampus of developing rats. The increase in PCr:Cr ratio in the STZ group indicates lower demand for ATP and PCr, secondary to decreased neuronal activity, which has been demonstrated in previous studies. PCr:Cr ratio of the STZ+INS group was no different than control, indicating that intranasal insulin reverses the negative effect on neuronal activity caused by neonatal hyperglycemia.

scholarly journals Impact of a Multifactorial Educational Training on the Management of Preterm Infants in the Central-Eastern European Region

2021 ◽  
Vol 9 ◽  
Author(s):  
Philipp Steinbauer ◽  
Katrin Klebermass-Schrehof ◽  
Francesco Cardona ◽  
Katharina Bibl ◽  
Tobias Werther ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Best Practice ◽  
Eastern European ◽  
Educational Training ◽  
Improved Outcomes ◽  
Respiratory Management ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Central Eastern

Background: Differences in management and outcomes of extremely preterm infants have been reported across European countries. Implementation of standardized guidelines and interventions within existing neonatal care facilities can improve outcomes of extremely preterm infants. This study evaluated whether a multifactorial educational training (MET) course in Vienna focusing on the management of extremely preterm infants had an impact on the management of extremely preterm infants in Central-Eastern European (CEE) countries.Methods: Physicians and nurses from different hospitals in CEE countries participated in a two-day MET in Vienna, Austria with theoretical lectures, bedside teaching, and simulation trainings. In order to evaluate the benefit of the workshops, participants had to complete pre- and post-workshop questionnaires, as well as follow-up questionnaires three and twelve months after the MET.Results: 162 participants from 15 CEE countries completed the two-day MET at our department. Less invasive surfactant administration (LISA) was only used by 39% (63/162) of the participants. After the MET, 80% (122/152) were planning to introduce LISA, and 66% (101/152) were planning to introduce regular simulation training, which was statistically significantly increased three and twelve months after the MET. Thirty-six percent and 57% of the participants self-reported improved outcomes three and twelve months after the MET, respectively.Conclusion: Our standardized training in Vienna promoted the implementation of different perinatal concepts including postnatal respiratory management using LISA as well as regular simulation trainings at the participants' home departments. Moreover, our MET contributed to dissemination of guidelines, promoted best-practice, and improved self-reported outcomes.

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