Behavioral Organization in Infants with Intraventricular Hemorrhage: Characteristics and Clinical Implications

2018 ◽  
Vol 37 (5) ◽  
pp. 310-318
Author(s):  
Vanessa Maziero Barbosa ◽  
Jean Powlesland
Keyword(s):  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Brain Lesion ◽  
Clinical Implications ◽  
Behavioral Regulation ◽  
Behavioral Organization ◽  
Postmenstrual Age ◽  
Low Threshold ◽  
Over Time

PurposeThis study examined the neurobehavioral functioning in preterm infants diagnosed with intraventricular hemorrhage (IVH) grades III and IV, using the Assessment of Preterm Infants’ Behavior (APIB).Design and SampleThe APIB was completed on nine infants with IVH III/IV at 36 and 40weeks postmenstrual age to determine the effects of IVH on the neurobehavioral functioning and maturation over time. The APIB neurobehavioral scores (i.e., physiologic, motor, state, attention/interaction, regulatory, and examiner facilitation subsystem scores) were examined in relation to the two different testing times and to infants without lesion.ResultsAPIB scores at 36weeks suggested easily disorganized and poorly modulated behavioral regulation and low threshold of disorganization and stress. At 40 weeks, poor overall behavioral regulation persisted; only motor differences statistically improved between the two ages. Neurobehavior was significantly poor in all but state subsystems when tested at both ages in infants with a brain lesion.

Early Detection of Delayed Myelination in Preterm Infants

PEDIATRICS ◽  
1989 ◽  
Vol 84 (3) ◽  
pp. 407-411
Author(s):  
Margot van de Bor ◽  
Gerard L. Guit ◽  
Anneke M. Schreuder ◽  
John Wondergem ◽  
G. Jan Vielvoye
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Periventricular Leukomalacia ◽  
Resonance Imaging ◽  
Term Infants ◽  
Postmenstrual Age ◽  
The Central Nervous System ◽  
Delayed Myelination

Myelination of the central nervous system can be demonstrated with magnetic resonance imaging. The influence of periventricular-intraventricular hemorrhage and periventricular leukomalacia on cerebral myelination was studied using magnetic resonance imaging. The subjects were 33 preterm infants of less than 30 weeks' gestation studied at 44 weeks' postmenstrual age: 11 infants with periventricular-intraventricular hemorrhage, 7 with periventricular leukomalacia, and 15 without periventricular-intraventricular hemorrhage or periventricular leukomalacia. There were no differences in mean gestational age and birth weight between the three groups. However, infants without periventricular-intraventricular hemorrhage or periventricular leukomalacia had significantly less respiratory distress syndrome. At 44 weeks postmenstrual age, infants with periventricular leukomalacia had a significantly delayed myelination pattern (stage M2) in comparison with infants without periventricular-intraventricular hemorrhage or periventricular leukomalacia and infants with periventricular-intraventricular hemorrhage (stages M3 and M4). The latter two groups had myelination stages that were similar to those of healthy term infants at 44 weeks' postmenstrual age. The results demonstrate that periventricular leukomalacia causes delayed myelination of the cerebrum, whereas periventricular-intraventricular hemorrhage does not.

Value of Cranial Ultrasound and Magnetic Resonance Imaging in Predicting Neurodevelopmental Outcome in Preterm Infants

PEDIATRICS ◽  
1992 ◽  
Vol 90 (2) ◽  
pp. 196-199
Author(s):  
Margot van de Bor ◽  
Lya den Ouden ◽  
Gerard L. Guit
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Preterm Infants ◽  
Predictive Factor ◽  
Intraventricular Hemorrhage ◽  
Periventricular Leukomalacia ◽  
Neurodevelopmental Outcome ◽  
Cranial Ultrasound ◽  
Resonance Imaging ◽  
Postmenstrual Age

In this prospective study, cranial ultrasound was performed to detect periventricular-intraventricular hemorrhage and periventricular leukomalacia in 33 preterm infants of less than 32 weeks' gestation. At 44 weeks postmenstrual age magnetic resonance imaging was performed to detect the stage of myelination. Neurodevelopmental outcome was assessed at 3 years of age in 31 children (2 children died in the first year of life). Significant correlations were found between neurodevelopmental outcome and ultrasound findings (χ2 = 32.8; P < .0001) and stage of myelination (χ2 = 20.5; P < .0005). To establish the criterion with the best predictive factor, multiple regression analysis was performed with outcome as dependent variable and periventricular-intraventricular hemorrhage, periventricular leukomalacia, and stage of myelination as independent variables. It appeared that the detection of periventricular leukomalacia with ultrasound showed the best predictive factor for neurodevelopmental outcome. Routine magnetic resonance imaging at 44 weeks postmenstrual age should not be performed just for the purpose of predicting neurodevelopmental outcome more reliably.

scholarly journals The Effect of Severe Intraventricular Hemorrhage on the Biorhythms of Feeding in Premature Infants

2021 ◽  
Vol 9 ◽  
Author(s):  
Ira H. Gewolb ◽  
Babatunde T. Sobowale ◽  
Frank L. Vice ◽  
Abhijit Patwardhan ◽  
Nino Solomonia ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Neurological Injury ◽  
Independent Effect ◽  
Neurologic Injury ◽  
Developmentally Regulated ◽  
Postmenstrual Age ◽  
Feeding Rhythms ◽  
Grade 3

Background: Suck-swallow rhythmicity and the integration of breathing into infant feeding are developmentally regulated. Neurological injury and breathing abnormalities can both impact feeding in preterm infants.Objective: To determine the effects of neurologic injury independent of effects of disordered breathing on feeding biorhythms in premature infants.Methods: Low-risk preterm infants (LRP), infants with Grade 3–4 Intraventricular Hemorrhage (IVH), those with bronchopulmonary dysplasia (BPD), and those with both BPD and IVH (BPD+IVH) were identified. Forty-seven infants, 32–42 weeks Postmenstrual Age (PMA) were evaluated on one or more occasions (131 studies). Of these, 39 infants (81 studies) were performed at >35 weeks PMA. Coefficient of variation (COV) (=standard deviation of the inter-event (e.g., suck-suck, swallow-breath, etc.) interval divided by the mean of the interval) was used to quantify rhythmic stability.Results: To adjust for PMA, only those infants >35–42 weeks were compared. Suck-suck COV was significantly lower (more rhythmically stable) in the LRP group [COV = 0.274 ± 0.051 (S.D.)] compared to all other groups (BPD = 0.325 ± 0.066; IVH = 0.342 ± 0.072; BPD + IVH = 0.314 ± 0.069; all p < 0.05). Similarly, suck-swallow COV was significantly lower in LRP babies (0.360 ± 0.066) compared to the BPD group (0.475 ± 0.113) and the IVH cohort (0.428 ± 0.075) (p < 0.05). The BPD+IVH group (0.424 ± 0.109), while higher, was not quite statistically significant.Conclusions: Severe IVH negatively impacts suck-suck and suck-swallow rhythms. The independent effect of neurological injury in the form of IVH on feeding rhythms suggests that quantitative analysis of feeding may reflect and predict neurological sequelae.

Osteopathic status of preterm infants with intraventricular hemorrhage

2020 ◽  
pp. 64-73
Author(s):  
L. K. Karimova ◽  
J. O. Kuzmina ◽  
Z. N. Zinnurova ◽  
E. M. Vasilevskaja
Keyword(s):  
Preterm Infants ◽  
Intraventricular Hemorrhage

scholarly journals Sex-Specific Long-Term Trends in Length of Hospital Stay, Postmenstrual Age at Discharge, and Survival in Very Low Birth Weight Infants

Neonatology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Matthias Fröhlich ◽  
Tatjana Tissen-Diabaté ◽  
Christoph Bührer ◽  
Stephanie Roll
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Hospital Stay ◽  
Very Low Birth Weight ◽  
Survival Rates ◽  
Length Of Hospital Stay ◽  
Mortality Rates ◽  
Vlbw Infants ◽  
Postmenstrual Age ◽  
Over Time

<b><i>Introduction:</i></b> In very low birth weight (&#x3c;1,500 g, VLBW) infants, morbidity and mortality have decreased substantially during the past decades, and both are known to be lower in girls than in boys. In this study, we assessed sex-specific changes over time in length of hospital stay (LOHS) and postmenstrual age at discharge (PAD), in addition to survival in VLBW infants. <b><i>Methods:</i></b> This is a single-center retrospective cohort analysis based on quality assurance data of VLBW infants born from 1978 to 2018. Estimation of sex-specific LOHS over time was based on infants discharged home from neonatal care or deceased. Estimation of sex-specific PAD over time was based on infants discharged home exclusively. Analysis of in-hospital survival was performed for all VLBW infants. <b><i>Results:</i></b> In 4,336 of 4,499 VLBW infants admitted from 1978 to 2018 with complete data (96.4%), survival rates improved between 1978–1982 and 1993–1997 (70.8 vs. 88.3%; hazard ratio (HR) 0.20, 95% confidence interval 0.14, 0.30) and remained stable thereafter. Boys had consistently higher mortality rates than girls (15 vs. 12%, HR 1.23 [1.05, 1.45]). Nonsurviving boys died later compared to nonsurviving girls (adjusted mean survival time 23.0 [18.0, 27.9] vs. 20.7 [15.0, 26.3] days). LOHS and PAD assessed in 3,166 survivors displayed a continuous decrease over time (1978–1982 vs. 2013–2018: LOHS days 82.9 [79.3, 86.5] vs. 60.3 [58.4, 62.1] days); PAD 40.4 (39.9, 40.9) vs. 37.4 [37.1, 37.6] weeks). Girls had shorter LOHS than boys (69.4 [68.0, 70.8] vs. 73.0 [71.6, 74.4] days) and were discharged with lower PAD (38.6 [38.4, 38.8] vs. 39.2 [39.0, 39.4] weeks). <b><i>Discussion/Conclusions:</i></b> LOHS and PAD decreased over the last 40 years, while survival rates improved. Male sex was associated with longer LOHS, higher PAD, and higher mortality rates.

scholarly journals Factors associated with neurodevelopment in preterm infants with systematic inflammation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eun Sun Lee ◽  
Ee-Kyung Kim ◽  
Seung han Shin ◽  
Young-Hun Choi ◽  
Young Hwa Jung ◽  
...  
Keyword(s):  
White Matter ◽  
Preterm Infants ◽  
Systemic Inflammation ◽  
Head Circumference ◽  
Brain Mri ◽  
White Matter Injury ◽  
Social Emotional ◽  
Postmenstrual Age ◽  
Neurodevelopmental Impairment ◽  
Near Term

Abstract Background Several studies have suggested that adverse neurodevelopment could be induced by systemic inflammation in preterm infants. We aimed to investigate whether preterm infants with systemic inflammation would have impaired neurodevelopment and which biomarkers and neurophysiologic studies during inflammation are associated with poor neurodevelopment. Methods This prospective cohort study enrolled infants born before 30 weeks of gestation or with birth weight < 1250 g. Infants were grouped according to the presence of systemic inflammation: Control (no inflammation, n = 49), I (systemic inflammation, n = 45). Blood and cerebrospinal fluid samples for markers of brain injury and inflammation were collected and amplitude-integrated electroencephalography (aEEG) was performed within 4 h of septic workup. We evaluated aEEG at 35 weeks postmenstrual age (PMA), head circumference at 36 weeks PMA, and brain MRI at discharge. The Bayley Scales of Infant and Toddler Development III (Bayley-III) was performed at a corrected age (CA) of 18 months. Results The I group had more white matter injuries (2 vs. 26.7%, Control vs. I, respectively) at the time of discharge, lower brain functional maturation (9.5 vs. 8), and smaller head size (z-score − 1.45 vs. -2.12) at near-term age and poorer neurodevelopment at a CA of 18 months than the control (p < 0.05). Among the I group, the proportion of immature neutrophils (I/T ratios) and IL-1 beta levels in the CSF were associated with aEEG measures at the day of symptom onset (D0). Seizure spike on aEEG at D0 was significantly correlated with motor and social-emotional domains of Bayley-III (p < 0.05). The I/T ratio and CRP and TNF-α levels of blood at D0, white matter injury on MRI at discharge, head circumference and seizure spikes on aEEG at near-term age were associated with Bayley-III scores at a CA of 18 months. Conclusions Systemic inflammation induced by clinical infection and NEC are associated with neurodevelopmental impairment in preterm infants. The seizure spike on aEEG, elevated I/T ratio, CRP, and plasma TNF-alpha during inflammatory episodes are associated with poor neurodevelopment.

Cerebral Oxygenation and Perfusion When Positioning Preterm Infants: Clinical Implications

2021 ◽  
Author(s):  
Pranav R. Jani ◽  
Krista Lowe ◽  
Aldo Perdomo ◽  
Lorraine Wakefield ◽  
Murray Hinder ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Cerebral Oxygenation ◽  
Clinical Implications
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