Neonatal seizures in extremely preterm infants with very and extremely low birth weight: prevalence and transformation into structural epilepsy

2021 ◽  
Vol 10_2021 ◽  
pp. 134-142
Author(s):  
Suvorov I.A. Suvorov ◽  
Amirkhanova D.Yu. Amirkhanova ◽  
Degtyareva A.V. Degtyareva ◽  
Degtyarev D.N. Degtyarev D ◽  
Albegova M.B. Albegova ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Extremely Low Birth Weight ◽  
Neonatal Seizures ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Structural Epilepsy

scholarly journals Concentrated Preterm Formula as a Liquid Human Milk Fortifier at Initiation Stage in Extremely Low Birth Weight Preterm Infants: Short Term and 2-year Follow-up Outcomes

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2229 ◽  
Author(s):  
Yung-Chieh Lin ◽  
Yen-Ju Chen ◽  
Chao-Ching Huang ◽  
Chi-Chang Shieh
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Volume Ratio ◽  
Extremely Low Birth Weight ◽  
Improvement Project ◽  
Preterm Formula ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Human milk (HM) must be accurately fortified for extremely low birth weight (ELBW) preterm infants with human milk fortifiers (HMFs). Powdered HMF has some limitations in terms of sterilization and accuracy. A concentrated preterm formula (CPF) may serve as a safe liquid HMF to facilitate growth. Hence, we launched a quality improvement project for fortification accuracy of minute volume HM. A CPF, Similac Special Care 30 (SSC30), was newly introduced as an HMF when daily feeding reached 100 cm3/kg. CPF + HM (1:2 volume ratio), CPF + HM (1:1 volume ratio), and powdered HMF + HM (1 packet in 25 cm3) represented three fortification stages. Fortification shifted to powdered HMF while tolerable feeding reached 25 cm3/meal. The outcome was compared before (Period-I, January 2015 to June 2016, n = 37) and after the new implement (Period-II, July 2016 to December 2017, n = 36). Compared with the Period-I group, the Period-II group had significantly higher daily enteral milk intake in the first 4 weeks of life, and higher percentages of fortification in the HM-fed infants in the first 8 weeks after birth. The Period-II group also significantly increased in body weight growth in terms of z-score at term equivalent age (p = 0.04) and had better language and motor performance at 24 months old (p = 0.048 and p = 0.032, respectively). Using the liquid CPF as a strategical alternative fortification of HM might be beneficial for extremely preterm infants in terms of growth as well as neurodevelopment.

scholarly journals Az extrém kis születési súlyú koraszülöttek fejlődésének követése az óvodáskor végéig a perinatalis szövődmények tükrében

2018 ◽  
Vol 159 (41) ◽  
pp. 1672-1679
Author(s):  
Anett Nagy ◽  
Anna Mária Beke ◽  
Renáta Cserjési ◽  
Rózsa Gráf ◽  
Magda Kalmár
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Developmental Outcomes ◽  
Extremely Low Birth Weight ◽  
Psychomotor Development ◽  
Preterm Children ◽  
Extremely Preterm ◽  
The Mean

Abstract: Introduction: Owing to the rapid progress of the medical science and technology, the chances of survival of the extremely low birth weight (<1000 g) preterm babies have dramatically improved. Nevertheless, the research findings on their long-term developmental outcome are inconsistent. Aim: Our study has attempted to contribute to the understanding of the developmental mechanisms in the extremely low birth weight preterm infants and to the prediction of the developmental outcomes taking into account of the risk factors of development. Method: 34 preterm children who were free of any major central nervous system injury were followed up from one to 5–6 years of age. The psychomotor development of the infants was assessed at 1 and 2 years of age and, at 5–6 years of age, intelligence tests were administered to the children. Perinatal and environmental factors were included in the data analysis. Results: The extremely low birth weight preterm children as a group displayed no developmental delay at any of the measurement points. The mean developmental quotients were 98.6 and 106.6 at ages 1 and 2 years, respectively. At 5–6 years of age, the mean verbal IQ was 101.4, while the mean performance IQ was 92.9. Behind the group means there was a wide range of individual variations. The most powerful contributors to the developmental outcomes were birth weight, bronchopulmonary dysplasia, intra-uterine growth retardation, gender, and maternal education. The girls had a significant advantage over the boys in language development. Verbal intelligence was hampered by intracranial hemorrhage, while intrauterine growth restriction had a similar effect on the performance IQ. Conclusions: Our results suggest that even the extremely preterm infants may have rather good chances of satisfactory mental development. However, the individual developmental prospects are influenced by a great number of domain-specific risk- and protective factors. Although at a group-level, infant psychomotor development is a significant predictor of later intelligence quotient, the rate of development may change at any age. The phenomenon of “moving risk” underscores the importance of the long-term follow-up of preterm infants. Orv Hetil. 2018; 159(41): 1672–1679.

Histomorphometric Analysis of Postnatal Glomerulogenesis in Extremely Preterm Infants

2004 ◽  
Vol 7 (1) ◽  
pp. 17-25 ◽  
Author(s):  
Maria M. Rodríguez ◽  
Alexander H. Gómez ◽  
Carolyn L. Abitbol ◽  
Jayanthi J. Chandar ◽  
Shahnaz Duara ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Extremely Low Birth Weight ◽  
Preterm Neonates ◽  
Computer Assisted ◽  
Compensatory Mechanisms ◽  
Long Survival ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Until now oligonephropathy to indicate “too few nephrons” has been associated with intrauterine growth restriction and experimentally induced abnormalities of renal development. The purpose of this study was to determine whether there is evidence of abnormal postnatal glomerulogenesis in extremely low birth weight preterm infants. Renal autopsy tissue was studied by computer-assisted morphometry from 56 extremely premature infants (birth weight ≤ 1000 g) and 10 fullterm infants as controls. Preterm infants were divided into two groups (short survival < 40 days vs. long survival ≥40 days). Each group was subdivided into those with renal failure (RF) and those with normal renal function. Forty-two of 56 preterm infants (75%) were adequate for gestational age. Glomerulogenesis as measured by radial glomerular counts (RGC) was markedly decreased in all preterm infants as compared to term controls and correlated significantly with gestational age ( r = 0.87; P < 0.001). Active glomerulogenesis with “basophilic S-shaped bodies” was absent in longer surviving preterm and all term infants. RGC of preterm infants surviving ≥40 days with RF were significantly less than RGC of those with long survival and no RF ( P < 0.001). Only this latter group demonstrated increased glomerular size as measured by mesangial tuft area and Bowman's capsule area compared to all other groups ( P < 0.001). The kidney continues to form postnatally in preterm neonates, but glomerulogenesis ceases after 40 days. Moreover, it is further inhibited by RF. Compensatory mechanisms in longer surviving preterm infants include glomerular hypertrophy and mesangial proliferation that could lead to hyperfiltration.

Identifying Clinical Phenotypes in Extremely Low Birth Weight Infants – A Machine Learning Approach

2021 ◽  
Author(s):  
Felipe Yu Matsushita ◽  
Vera Lucia Jornada Krebs ◽  
Werther Brunow de Carvalho
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Phenotypic Characterization ◽  
Future Research ◽  
Low Birth Weight Infants ◽  
Mechanically Ventilated ◽  
Individualized Care ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Abstract There is increasing evidence that patient heterogeneity significantly hinders advancement in clinical trials and individualized care. This study aimed to identify distinct phenotypes in extremely low birth weight infants. We performed an agglomerative hierarchical clustering on principal components. Cluster validation was performed by cluster stability assessment with bootstrapping method. A total of 215 newborns (median gestational age 27 [26–29] weeks) were included in the final analysis. Six clusters with different clinical and laboratory characteristics were identified: the “Mature” (Cluster 1; n = 60, 27.9%), the mechanically ventilated with “adequate ventilation” (Cluster 2; n = 40, 18.6%), the mechanically ventilated with “poor ventilation” (Cluster 3; n = 39, 18.1%), the “extremely immature” (Cluster 4; n = 39, 18.1%%), the neonates requiring “Intensive Resuscitation” in the delivery room (Cluster 5; n = 20, 9.3%), and the “Early septic” group (Cluster 6; n = 17, 7.9%). In-hospital mortality rates were 11.7%, 25%, 56.4%, 61.5%, 45%, and 52.9%, while severe intraventricular hemorrhage rates were 1.7%, 5.3%, 29.7%, 47.2%, 44.4%, and 28.6% in clusters 1,2,3,4,5, and 6, respectively (p < 0.001). Conclusions: Our cluster analysis in extremely preterm infants was able to characterize six distinct phenotypes. Future research should explore how better phenotypic characterization of neonates might improve care and prognosis.

scholarly journals Lactobacillus reuteri Colonisation of Extremely Preterm Infants in a Randomised Placebo-Controlled Trial

2021 ◽  
Vol 9 (5) ◽  
pp. 915
Author(s):  
Johanne E. Spreckels ◽  
Erik Wejryd ◽  
Giovanna Marchini ◽  
Baldvin Jonsson ◽  
Dylan H. de Vries ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Lactobacillus Reuteri ◽  
Controlled Trial ◽  
Probiotic Strain ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Head Growth ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Lactobacillus reuteri DSM 17938 supplementation reduces morbidities in very low birth weight infants (<1500 g), while the effect on extremely low birth weight infants (ELBW, <1000 g) is still questioned. In a randomised placebo-controlled trial (ClinicalTrials.gov ID NCT01603368), head growth, but not feeding tolerance or morbidities, improved in L. reuteri-supplemented preterm ELBW infants. Here, we investigate colonisation with the probiotic strain in preterm ELBW infants who received L. reuteri DSM 17938 or a placebo from birth to postmenstrual week (PMW) 36. Quantitative PCR was used on 582 faecal DNA samples collected from 132 ELBW infants at one, two, three, and four weeks, at PMW 36, and at two years of age. Human milk oligosaccharides were measured in 31 milk samples at two weeks postpartum. At least 86% of the ELBW infants in the L. reuteri group were colonised with the probiotic strain during the neonatal period, despite low gestational age, high antibiotic pressure, and independent of infant feeding mode. Higher concentrations of lacto-N-tetraose, sialyl-lacto-N-neotetraose c, and 6′-sialyllactose in mother’s milk weakly correlated with lower L. reuteri abundance. Within the L. reuteri group, higher L. reuteri abundance weakly correlated with a shorter time to reach full enteral feeding. Female sex and L. reuteri colonisation improved head growth from birth to four weeks of age. In conclusion, L. reuteri DSM 17938 supplementation leads to successful colonisation in ELBW infants.

Is intravenous fish oil associated with the neurodevelopment of extremely low birth weight preterm infants on parenteral nutrition?

2021 ◽  
Author(s):  
Chiara Biagetti ◽  
Alessio Correani ◽  
Rita D’Ascenzo ◽  
Enrica Ferretti ◽  
Cecilia Proietti ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Preterm Infants ◽  
Extremely Low Birth Weight

scholarly journals Microstructural Measures of the Inferior Longitudinal Fasciculus Predict Later Cognitive and Language Development in Infants Born With Extremely Low Birth Weight

2021 ◽  
pp. 088307382110198
Author(s):  
Matthew C. Bugada ◽  
Julia E. Kline ◽  
Nehal A. Parikh
Keyword(s):  
Diffusion Tensor Imaging ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Language Development ◽  
Fractional Anisotropy ◽  
Diffusion Tensor ◽  
Structural Mri ◽  
Extremely Low Birth Weight ◽  
Extremely Preterm ◽  
Inferior Longitudinal Fasciculus

Objective: Extremely preterm children are at high risk for adverse neurodevelopmental outcomes. Identifying predictors of discrete developmental outcomes early in life would allow for targeted neuroprotective therapies when neuroplasticity is at its peak. Our goal was to examine whether diffusion magnetic resonance imaging (MRI) metrics of the inferior longitudinal and uncinate fasciculi early in life could predict later cognitive and language outcomes. Study Design: In this pilot study, 43 extremely low-birth-weight preterm infants were scanned using diffusion MRI at term-equivalent age. White matter tracts were assessed via diffusion tensor imaging metrics of fractional anisotropy and mean diffusivity. The Language and Cognitive subscale scores of the Bayley Scales of Infant & Toddler Development-III at 18-22 months corrected age were our outcomes of interest. Multiple linear regression models were created to assess diffusion metrics of the inferior longitudinal and uncinate fasciculi as predictors of Bayley scores. We controlled for brain injury score on structural MRI, maternal education, birth weight, and age at MRI scan. Results: Of the 43 infants, 36 infants had high-quality diffusion tensor imaging and returned for developmental testing. The fractional anisotropy of the inferior longitudinal fasciculus was associated with Bayley-III scores in univariate analyses and was an independent predictor of Bayley-III cognitive and language development over and above known predictors in multivariable analyses. Conclusions: Incorporating new biomarkers such as the fractional anisotropy of the inferior longitudinal fasciculus with structural MRI findings could enhance accuracy of neurodevelopment predictive models. Additional research is needed to validate our findings in a larger cohort.

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