Below median birth weight in appropriate-for-gestational-age preterm infants as a risk factor for bronchopulmonary dysplasia

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 < 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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The Post-Discharge Growth of Very Low Birth Weight Preterm Infants

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2020.1023 ◽

2020 ◽

pp. 1

Author(s):

Tuba Ozdemir ◽

Abdullah Baris Akcan ◽

Munevver Kaynak Turkmen

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Gestational Age ◽

Very Low Birth Weight ◽

Ductus Arteriosus ◽

Somatic Growth ◽

Growth Time ◽

Appropriate For Gestational Age ◽

Catch Up

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.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.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.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.

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Late hyponatremia: its risk factors in preterm infants and short-term outcome

Medical Journal of Tabriz University of Medical Sciences ◽

10.34172/mj.2021.069 ◽

2021 ◽

Vol 43 (5) ◽

pp. 434-443

Author(s):

Manizheh Gharehbaghi ◽

Sadollah Yegane Dust ◽

Elmira Naseri

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Gestational Age ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome ◽

Osteopenia Of Prematurity

Background. Prematurity is one of the major health problems and common causes of neonatal mortality. One of the complications of premature infants is hyponatremia. The effect of hyponatremia on the prognosis of preterm infants has not been well studied. This study aimed to evaluate infants with late hyponatremia, its risk factors, and prognosis. Methods. This descriptive analytical study reviewed preterm infants (<34 weeks) admitted to Al-Zahra or Children’s Hospital in Tabriz for one year (2019). Neonates diagnosed with hyponatremia after the second week were identified and evaluated for risk factors and short-term outcome. Results. A total of 186 neonates were studied. The mean gestational age of the neonates was 30 weeks (first and third quarters = 29-32 weeks). 101 (54.3%) infants were male. The route of delivery was the cesarean section in 60.7% of cases. Late hyponatremia was present in 50 (26.8 %) infants. Gestational age and birth weight were significantly lower in infants with hyponatremia than in the control group. Multivariate analysis showed that low birth weight, the use of prenatal steroids, and inappropriate weight for gestational age status independently predict the incidence of late hyponatremia. There was a significant relationship between the presence of prolonged late hyponatremia (over 7 days) and bronchopulmonary dysplasia and osteopenia of prematurity. However, no significant association was found between the presence of prolonged late hyponatremia in preterm infants with the length of hospital stay and in-hospital mortality. Conclusion. Based on the findings of this study, low birth weight, prenatal steroid use, and lack of appropriate weight for gestational age were risk factors for late hyponatremia in preterm infants. Prolonged hyponatremia is associated with bronchopulmonary dysplasia and osteopenia of prematurity

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The Correlation Between Bronchopulmonary Dysplasia and Platelet Metabolism in Preterm Infants

Frontiers in Pediatrics ◽

10.3389/fped.2021.670469 ◽

2021 ◽

Vol 9 ◽

Author(s):

Longli Yan ◽

Zhuxiao Ren ◽

Jianlan Wang ◽

Xin Xia ◽

Liling Yang ◽

...

Keyword(s):

Platelet Count ◽

Birth Weight ◽

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Premature Infants ◽

Gestational Age ◽

Admission Diagnosis ◽

Control Group ◽

The Relationship

Background: Platelets play an important role in the formation of pulmonary blood vessels, and thrombocytopenia is common in patients with pulmonary diseases. However, a few studies have reported on the role of platelets in bronchopulmonary dysplasia.Objective: The objective of the study was to explore the relationship between platelet metabolism and bronchopulmonary dysplasia in premature infants.Methods: A prospective case-control study was performed in a cohort of premature infants (born with a gestational age <32 weeks and a birth weight <1,500 g) from June 1, 2017 to June 1, 2018. Subjects were stratified into two groups according to the diagnostic of bronchopulmonary dysplasia: with bronchopulmonary dysplasia (BPD group) and without bronchopulmonary dysplasia (control group). Platelet count, circulating megakaryocyte count (MK), platelet-activating markers (CD62P and CD63), and thrombopoietin (TPO) were recorded and compared in two groups 28 days after birth; then serial thrombopoietin levels and concomitant platelet counts were measured in infants with BPD.Results: A total of 252 premature infants were included in this study. Forty-eight premature infants developed BPD, 48 premature infants without BPD in the control group who were matched against the study infants for gestational age, birth weight, and admission diagnosis at the age of postnatal day 28. Compared with the controls, infants with BPD had significantly lower peripheral platelet count [BPD vs. controls: 180.3 (24.2) × 109/L vs. 345.6 (28.5) × 109/L, p = 0.001]. Circulating MK count in the BPD group was significantly more abundant than that in the control group [BPD vs. controls: 30.7 (4.5)/ml vs. 13.3 (2.6)/ml, p = 0.025]. The level of CD62p, CD63, and TPO in BPD group was significantly higher than the control group [29.7 (3.1%) vs. 14.5 (2.5%), 15.4 (2.0%) vs. 5.8 (1.7%), 301.4 (25.9) pg/ml vs. 120.4 (14.2) pg/ml, all p < 0.05]. Furthermore, the concentration of TPO was negatively correlated with platelet count in BPD group with thrombocytopenia.Conclusions: Our findings suggest that platelet metabolism is involved in the development of BPD in preterm infants. The possible mechanism might be through increased platelet activation and promoted TPO production by feedback.

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

Paediatrica Indonesiana ◽

10.14238/pi45.4.2005.154-9 ◽

2016 ◽

Vol 45 (4) ◽

pp. 154 ◽

Cited By ~ 1

Author(s):

Stanza Uga Peryoga ◽

Abdurachman Sukadi ◽

Sambas Wiradisuria

Keyword(s):

Logistic Regression ◽

Birth Weight ◽

High Risk ◽

Low Birth Weight ◽

Preterm Infants ◽

Gestational Age ◽

Bivariate Analysis ◽

Moderate Risk ◽

Appropriate For Gestational Age ◽

Delayed Development

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

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Is being small for gestational age a risk factor for retinopathy of prematurity? A study with 345 very low birth weight preterm infants

Jornal de Pediatria ◽

10.2223/jped.1870 ◽

2009 ◽

Vol 85 (1) ◽

pp. 48-54 ◽

Cited By ~ 18

Author(s):

João Borges Fortes Filho ◽

Fabiana Borba Valiatti ◽

Gabriela Unchalo Eckert ◽

Marlene Coelho da Costa ◽

Rita C. Silveira ◽

...

Keyword(s):

Risk Factor ◽

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Small For Gestational Age ◽

Very Low Birth Weight

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Insensible Water Loss in Preterm Infants: Changes With Postnatal Development and Non-ionizing Radiant Energy

PEDIATRICS ◽

10.1542/peds.54.6.704 ◽

1974 ◽

Vol 54 (6) ◽

pp. 704-712

Author(s):

Paul Y. K. Wu. ◽

Joan E. Hodgman

Keyword(s):

Birth Weight ◽

Preterm Infants ◽

Temperature Control ◽

Gestational Age ◽

Water Loss ◽

Radiant Energy ◽

Radiant Heat ◽

The Third ◽

Threefold Increase ◽

Appropriate For Gestational Age

Insensible water loss (IWL) was measured by an Electronic Potter Baby Scale in 170 healthy preterm infants, with birthweights ranging from 800 to 2,000 gm, who were appropriate for gestational age. IWL was found to increase with decreasing birth weight, i.e., from a mean of 0.7 ml/kg/hr in infants weighing 1,751 to 2,000 gm to 2.67 ml/kg/hr in infants weighing < 1,000 gm. This correlation between IWL and birthweight was high (r = 0.91; P = < 0.001). In infants < 1,500 gm, IWL decreased with postnatal age while in infants > 1,500 gm, IWL increased in the second week and was stable in the third and fourth weeks. Exposure to non-ionizing radiant energy from three radiant heat warmers was found to increase IWL by 50% to 190% depending on the maturity of the infant and the type of warmers. Phototherapy was associated with a twofold to threefold increase in IWL, which can be minimized by careful temperature control of the infant. The magnitude of increase in IWL in response to exposure to non-ionizing radiant energy, both from radiant heat warmers and phototherapy was greater in infants with birthweight > 1,500 gm than in infants < 1,500 gm.

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Patterns of Infancy Growth and Metabolic Hormonal Profile Are Different in Very-Low-Birth-Weight Preterm Infants Born Small for Gestational Age Compared to Those Born Appropriate for Gestational Age

Hormone Research in Paediatrics ◽

10.1159/000487994 ◽

2018 ◽

Vol 89 (4) ◽

pp. 233-245 ◽

Cited By ~ 2

Author(s):

María Isabel Hernandez ◽

Katherine Rossel ◽

Veronica Peña ◽

Mirna Garcia ◽

Gabriel Cavada ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Gestational Age ◽

Small For Gestational Age ◽

Very Low Birth Weight ◽

Growth Patterns ◽

Early Recovery ◽

Hormonal Profile ◽

Appropriate For Gestational Age

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.

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A birth population-based survey of preterm morbidity and mortality by gestational age

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03726-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiaojing Guo ◽

Xiaoqiong Li ◽

Tingting Qi ◽

Zhaojun Pan ◽

Xiaoqin Zhu ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Preterm Infants ◽

Birth Defects ◽

Gestational Age ◽

Death Rate ◽

Preterm Births ◽

Mortality Rates ◽

Morbidity And Mortality ◽

Hospital Death

Abstract Background Despite 15–17 millions of annual births in China, there is a paucity of information on prevalence and outcome of preterm birth. We characterized the outcome of preterm births and hospitalized preterm infants by gestational age (GA) in Huai’an in 2015, an emerging prefectural region of China. Methods Of 59,245 regional total births, clinical data on 2651 preterm births and 1941 hospitalized preterm neonates were extracted from Huai’an Women and Children’s Hospital (HWCH) and non-HWCH hospitals in 2018–2020. Preterm prevalence, morbidity and mortality rates were characterized and compared by hospital categories and GA spectra. Death risks of preterm births and hospitalized preterm infants in the whole region were analyzed with multivariable Poisson regression. Results The prevalence of extreme, very, moderate, late and total preterm of the regional total births were 0.14, 0.53, 0.72, 3.08 and 4.47%, with GA-specific neonatal mortality rates being 44.4, 15.8, 3.7, 1.5 and 4.3%, respectively. There were 1025 (52.8% of whole region) preterm admissions in HWCH, with significantly lower in-hospital death rate of inborn (33 of 802, 4.1%) than out-born (23 of 223, 10.3%) infants. Compared to non-HWCH, three-fold more neonates in HWCH were under critical care with higher death rate, including most extremely preterm infants. Significantly all-death risks were found for the total preterm births in birth weight < 1000 g, GA < 32 weeks, amniotic fluid contamination, Apgar-5 min < 7, and birth defects. For the hospitalized preterm infants, significantly in-hospital death risks were found in out-born of HWCH, GA < 32 weeks, birth weight < 1000 g, Apgar-5 min < 7, birth defects, respiratory distress syndrome, necrotizing enterocolitis and ventilation, whereas born in HWCH, antenatal glucocorticoids, cesarean delivery and surfactant use decreased the death risks. Conclusions The integrated data revealed the prevalence, GA-specific morbidity and mortality rate of total preterm births and their hospitalization, demonstrating the efficiency of leading referral center and whole regional perinatal-neonatal network in China. The concept and protocol should be validated in further studies for prevention of preterm birth.

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Single-course antenatal corticosteroids is related to faster growth in very-low-birth-weight infant

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03510-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jiajia Jing ◽

Yiheng Dai ◽

Yanqi Li ◽

Ping Zhou ◽

Xiaodong Li ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Gestational Age ◽

Very Low Birth Weight ◽

Postnatal Growth ◽

Weight Increase ◽

Antenatal Corticosteroids ◽

Lung Maturation ◽

Growth Outcomes

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.

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