scholarly journals The risk for delayed development in low birth weight, appropriate for gestational age preterm infants

2016 ◽  
Vol 45 (4) ◽  
pp. 154 ◽  
Author(s):  
Stanza Uga Peryoga ◽  
Abdurachman Sukadi ◽  
Sambas Wiradisuria

Background Preterm infants, particularly those who have hadsevere asphyxia, hyperbilirubinemia, and sepsis, tend to be at riskfor neurodevelopmental impairment.Objective The purpose of this study was to assess the risk for de-layed development in low birth weight (LBW), appropriate for gesta-tional age (AGA) preterm infants compared to that in term, non-LBWinfants, and to investigate the roles of severe asphyxia, sepsis, andhyperbilirubinemia as potential risk factors for delayed development.Methods This was a hospital-based retrospective cohort studyinvolving preterm, LBW and term, non-LBW infants conducted inHasan Sadikin Hospital, Bandung. The Bayley InfantNeurodevelopmental Screener (BINS) test was performed to as-sess the risk of delayed development at 3 months of corrected agefor the preterm infants and at 3 months of chronological age for theterm infants. Bivariate analysis using the chi-square test and mul-tivariate analysis using logistic regression were performed.Results One hundred and twelve infants fulfilled eligibility criteria,consisting of 52 preterm, LBW and 60 term, non-LBW infants. Basedon the BINS test, of the preterm, LBW infants, 32 (61%) were atlow risk, 11 (21%) at moderate risk, and 9 (17%) at high risk fordelayed development. Of the control infants, 49 (82%) were at lowrisk, 10 (17%) at moderate risk, and 1 (1.7%) at high risk for de-layed development. Logistic regression analysis showed signifi-cant association between accompanying diseases such as sepsis(OR=25.60; P=0.001) and hyperbilirubinemia (OR=16.07; P=0.001)with delayed development. Despite more than twofold odds fordelayed development in infants with severe asphyxia (OR=2.51)and LBW-prematurity (OR=2.47), the association was statisticallyinsignificant (P=0.20 and P=0.15, respectively).Conclusions In preterm infants appropriate for gestational age,prematurity and low birth weight alone may or may not predisposeto delayed development at 3 months of age. However, the risk fordelayed development in such infants is increased when sepsis orhyperbilirubinemia is present

Author(s):  
Tuba Ozdemir ◽  
Abdullah Baris Akcan ◽  
Munevver Kaynak Turkmen

<p>OBJECTIVE: In the present study, we investigate the growth characteristics of very low birth weight premature infants of up to two years corrected age, considering the factors affecting growth and catch-up growth time.</p><p>STUDY DESIGN: The demographic data, clinical features, and comorbidities of 77 preterm infants with birth weights of less than or equal to 1.500 g were examined, the infants’ growth statuses in the 40th gestational week (gw) and at 6, 12, 18 and 24 months the corrected age, including their weight, height and head circumference, were evaluated.</p><p>RESULTS: The findings revealed that very low birth weight infants should be closely monitored either during their stay in the Neonatal Intensive Care Unit, or for up to 6 months corrected age, paying particular attention to growth data, and the appropriate supportive treatment should be administered. The applied support process is influential on the future somatic growth of preterm infants. It was noted in the study that bronchopulmonary dysplasia, proven sepsis, respiratory distress syndrome, steroid treatment for more than three days, patent ductus arteriosus, and ibuprofen treatment seemed to affect somatic growth negatively.</p><p>CONCLUSION: Small for gestational age newborns were found to catch up with appropriate for gestational age newborns at 2 years corrected age in terms of growth, although the percentage of catch-up growth during follow-up at the 40thgw, and at the 6th, 12th and 18th months was lower than that of appropriate for gestational age newborns.</p>


2008 ◽  
Vol 48 (1) ◽  
pp. 1 ◽  
Author(s):  
Anggraini Alam ◽  
Abdurachman Sukadi ◽  
Nelly Amalia Risan ◽  
Meita Dhamayanti

Background In developed countries, birth weight of less than1,500 g contributes in infant delayed development. It might bedifferent in developing countries.Objective This study aimed to determine whether preterm infantswith birth weight of 1,500 to 2,499 g are risk factors for delayeddevelopment at 7-10 months of age.Methods We analyzed singleton infants at 7-10 months ofcorrected age, born with birth weight of 1,500 to 2,499 grams,preterm-appropriate for gestational age (or LBW group), and at7-10 months of chronological age, born with birth weight >2,500g-term-appropriate for gestational (non-LBW group) in a hospital-based retrospective cohort study. Data were taken from medicalrecords in Hasan Sadikin Hospital, Bandung, from September2003 to May 2004. We excluded infants with major congenitalanomalies, hyaline membrane disease, assisted ventilation, orexchange transfusion. Multiple regression logistic analysis wasperformed for data analysis.Results The percentage of delayed development in LBW groupwas higher than in non-LBW group (17.1% vs. 1.6%). Logisticregression analysis revealed that low birth weight was a risk factorfor delayed development (RR=5.13, 95%Cl 1.55;16.96, P=0.007).Other biological risk factors for delayed development arehyperbilirubinemia (RR=3.32, 95%Cl 1.29;8.54, P=0.013) andsepsis (RR=2.74, 95%Cl 1.15;6.52, P=0.023).Conclusions Preterm-appropriate for gestational age with birthweight of 1,500 to 2,499 g are risk factors for infant delayeddevelopment after being adjusted to other biological risk factors.


2018 ◽  
Vol 89 (4) ◽  
pp. 233-245 ◽  
Author(s):  
María Isabel Hernandez ◽  
Katherine Rossel ◽  
Veronica Peña ◽  
Mirna Garcia ◽  
Gabriel Cavada ◽  
...  

Background/Aims: An increased preterm birth survival rate is associated with long-term neurological and metabolic risks; thus, our aim was to evaluate whether early patterns of infancy anthropometry and metabolic hormonal profile differ in preterm infants born small for gestational age (SGA) or appropriate for gestational age (AGA) from birth to 36 months of corrected age (CA). Methods: We recruited 110 very-low-birth-weight (VLBW) preterm infants (AGA = 60 and SGA = 50) with a mean birth weight of –2.39 ± 0.77 versus 0.57 ± 0.54 standard deviation scores (SDS) (p < 0.01) and birth length of –2.1 ± 1.05 versus –0.44 ± 0.82 SDS (p < 0.01), respectively. Anthropometry and blood sampling for insulin, insulin-like growth factor (IGF)-II, IGF-I, and leptin were performed for up to 3 years. Results: All neonates increased their weight, length, and head circumference SDS during the early inpatient period. Up to 90% reached a normal length within this period. The IGF-II, insulin, and glycemia concentrations changed in parallel with weight. In the first year of CA, only SGA infants gained weight and height SDS. The homoeostatic model assessment had a trend toward higher values in SGA infants at 24 and 36 months (p = 0.06 and p = 0.07). Conclusion: Being SGA is the strongest predictor of early recovery of height in VLBW preterm infants. Follow-up will allow us to determine whether the differences in the growth patterns of VLBW preterm infants by birth weight SDS persist.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiajia Jing ◽  
Yiheng Dai ◽  
Yanqi Li ◽  
Ping Zhou ◽  
Xiaodong Li ◽  
...  

Abstract Background Antenatal corticosteroids (ACS) treatment is critical to support survival and lung maturation in preterm infants, however, its effect on feeding and growth is unclear. Prior preterm delivery, it remains uncertain whether ACS treatment should be continued if possible (repeated course ACS), until a certain gestational age is reached. We hypothesized that the association of single-course ACS with feeding competence and postnatal growth outcomes might be different from that of repeated course ACS in very-low-birth-weight preterm infants. Methods A multicenter retrospective cohort study was conducted in very-low-birth-weight preterm infants born at 23–37 weeks’ gestation in South China from 2011 to 2014. Data on growth, nutritional and clinical outcomes were collected. Repeated course ACS was defined in this study as two or more courses ACS (more than single-course). Infants were stratified by gestational age (GA), including GA < 28 weeks, 28 weeks ≤ GA < 32 weeks and 32 weeks ≤ GA < 37 weeks. Multiple linear regression and multilevel model were applied to analyze the association of ACS with feeding and growth outcomes. Results A total of 841 infants were recruited. The results, just in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation, showed both single and repeated course of ACS regimens had shorter intubated ventilation time compared to non-ACS regimen. Single-course ACS promoted the earlier application of amino acid and enteral nutrition, and higher rate of weight increase (15.71; 95%CI 5.54–25.88) than non-ACS after adjusting for potential confounding factors. No associations of repeated course ACS with feeding, mean weight and weight increase rate were observed. Conclusions Single-course ACS was positively related to feeding and growth outcomes in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation. However, the similar phenomenon was not observed in the repeated course of ACS regimen.


PEDIATRICS ◽  
1981 ◽  
Vol 67 (3) ◽  
pp. 407-411
Author(s):  
R. K. Chandra

Groups of healthy, small-for-gestational age (SGA) and preterm appropriate-for-gestational age (AGA) infants were studied at birth, 1 month, 3 months, and 12 months of age. Serum thymic hormone (TH) activity was assayed, the number of T lymphocytes in the peripheral blood was counted, and in vitro lymphocyte stimulation responses to phytohemagglutinin (PHA) were evaluated. TH activity was decreased in 1-month-old SGA infants. T cells were reduced in all low birth weight infants; the number reverted to normal by 3 months of age in preterm AGA infants, whereas it remained low for at least 12 months in the SGA group. Lymphocyte stimulation response was decreased in low birth weight infants; the extent of depression paralleled reduction in T lymphocyte number. These observations indicate that cell-mediated immunity is impaired in low birth weight newborns and reduced TH activity may be one of the pathogenetic factors involved. Persistent depression of immunocompetence may underlie the increased susceptibility of SGA infants to infection-related morbidity and mortality.


PEDIATRICS ◽  
1993 ◽  
Vol 91 (3) ◽  
pp. 572-577
Author(s):  
David N. Greenberg ◽  
Bradley A. Yoder ◽  
Reese H. Clark ◽  
Clifford A. Butzin ◽  
Donald M. Null

Previous studies suggest that low birth weight black infants have less morbidity and birth-weight-specific mortality during the perinatal period than low birth weight white infants. We studied the effect of maternal race on outcome in preterm infants born at a military hospital that offers free access to obstetric and neonatal care. Between January 1, 1986, and December 31, 1991, data were prospectively collected on all 667 infants delivered at Wilford Hall USAF Medical Center with an estimated gestational age of less than 35 weeks. Three hundred ninety-two white infants and 165 black infants were included in the data analysis. The mean (±SD) birth weight was 1701 ± 65 g for white infants and 1462 ± 66 g for black infants. The mean estimated gestational age was 31.0 ± 3.2 weeks for white infants and 29.9 ± 3.8 weeks for black infants. Preeclampsia was more frequent in black mothers than in white mothers for the entire study population (21% vs 14%), but the birth weight differential between races remained after correction for preeclampsia. There were no significant differences between races in stillbirths, gender, maternal age, maternal transfer status, number of prenatal visits, or percentages of mothers with small-for-gestational-age infants, multiple-gestation infants, prolonged rupture of membranes, or initial prenatal visit during the first trimester. Intraventricular hemorrhage was more frequent in white infants at 27 through 29 weeks estimated gestational age (50% vs 13%). There were no significant differences between the two groups in survival or in the occurrence of severe infraventricular hemorrhage or bronchopulmonary dysplasia. It is concluded that preterm black infants are smaller than preterm white infants when matched for gestational age despite essentially equal utilization of prenatal care. However, maternal race has little direct effect on the survival of liveborn preterm infants in this population.


2019 ◽  
Vol 99 (12) ◽  
pp. 1690-1702 ◽  
Author(s):  
Yen-Ting Yu ◽  
Wan-Chi Huang ◽  
Wu-Shiun Hsieh ◽  
Jui-Hsing Chang ◽  
Chyi-Her Lin ◽  
...  

Abstract Background Family-centered intervention for preterm infants has shown short- to medium-term developmental benefits; however, the neurological effects of intervention have rarely been explored. Objective The objectives of this study were to examine the effect of a family-centered intervention program (FCIP) on neurophysiological functions in preterm infants with very low birth weight (VLBW; birth weight of &lt; 1500 g) in Taiwan, to compare the effect of the FCIP with that of a usual-care program (UCP), and to explore the FCIP-induced changes in neurobehavioral and neurophysiological functions. Design This was a multicenter, single-blind randomized controlled trial. Setting The study took place in 3 medical centers in northern and southern Taiwan. Participants Two hundred fifty-one preterm infants with VLBW were included. Intervention The FCIP group received a family-centered intervention and the UCP group received standard care during hospitalization. Measurements Infants were assessed in terms of neurobehavioral performance using the Neonatal Neurobehavioral Examination–Chinese version, and their neurophysiological function was assessed using electroencephalography/event-related potentials during sleep and during an auditory oddball task during the neonatal period. Results The FCIP promoted more mature neurophysiological function than the UCP, including greater negative mean amplitudes of mismatch negativities in the left frontal region in the oddball task in all infants, lower intrahemispheric prefrontal-central coherence during sleep in infants who were small for gestational age, and higher interhemispheric frontal coherence during sleep in those who were appropriate for gestational age. Furthermore, interhemispheric coherence was positively associated with the total neurobehavioral score in preterm infants who were appropriate for gestational age (r = 0.20). Limitations The fact that more parental adherence strategies were used in the FCIP group than in the UCP group might have favored the intervention effect in this study. Conclusions Family-centered intervention facilitates short-term neurophysiological maturation in preterm infants with VLBW in Taiwan.


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