Teenage, Lower-Class, Black Mothers and Their Preterm Infants: An Intervention and Developmental Follow-Up

Abstract Background Patent ductus arteriosus poses diagnostic and therapeutic dilemma for clinicians, diagnosis of persistent PDA, and determination of its clinical and hemodynamic significance are challenging. The aim of this study is to determine the prevalence of PDA in preterm infants admitted to our NICU, to report cardiac and respiratory complications of PDA, and to study the management strategies and their subsequent outcomes. Result Echocardiography was done for 152 preterm babies admitted to neonatal intensive care unit (NICU) on day 3 of life. Eighty-seven (57.2%) preterms had PDA; 54 (62.1%) non-hemodynamically significant PDA (non-hsPDA), and 33 (37.9%) hemodynamically significant PDA. Hemodynamically significant PDA received medical treatment (paracetamol 15 mg/kg/6 h IV for 3 days). Follow-up echocadiography was done on day 7 of life. Four babies died before echo was done on day 7. Twenty babies (68.9%) achieved closure after 1st paracetamol course. Nine babies received 2nd course paracetamol. Follow-up echo done on day 11 of life showed 4 (13.7%) babies achieved successful medical closure after 2nd paracetamol course; 5 babies failed closure and were assigned for surgical ligation. The group of non-hsPDA showed spontaneous closure after conservative treatment. Pulmonary hemorrhage was significantly higher in hsPDA group. Mortality was higher in hsPDA group than non-hsPDA group. Conclusion Echocardiographic evaluation should be done for all preterms suspected clinically of having PDA. We should not expose vulnerable population of preterm infants to medication with known side effects unnecessarily; we should limit medical closure of PDA to hsPDA. Paracetamol offers several important therapeutic advantages options being well tolerated and having more favorable side effects profile.

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Characterization of lung ultrasound imaging in preterm infants with bronchopulmonary dysplasia

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-211132 ◽

2021 ◽

pp. 1-13

Author(s):

Ying-Hua Sun ◽

Lin Yuan ◽

Yang Du ◽

Jian-Guo Zhou ◽

Sam Bill Lin ◽

...

Keyword(s):

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Neonatal Intensive Care ◽

Lung Ultrasound ◽

Imaging Method ◽

Chronic Lung Diseases ◽

Pleural Line ◽

Ultrasound Features

BACKGROUND: Lung ultrasound (LUS) is a bedside technique that can be used on diagnosis and follow-up of neonatal respiratory diseases. However, there are rare reports on the ultrasound features of bronchopulmonary dysplasia (BPD) which is one of the most common chronic lung diseases in preterm infants. OBJECTIVE: To describe the ultrasound features of different BPD levels, and to investigate the value of ultrasound in evaluating moderate-to-severe BPD. METHODS: In this prospective cohort study, newborns of less than 37 weeks’ gestational age in neonatal intensive care unit (NICU) were included. The LUS characteristics including pleural line, alveolar-interstitial syndrome (AIS), retrodiaphragmatic hyperechogenicity and diaphragmatic morphology were observed and recorded. The reliability of LUS in evaluating moderate and severe BPD were compared and calculated. RESULTS: A total of 108 infants were enrolled in our study: 39, 24, 29, 16 infants had non, mild, moderate and severe BPD. The median(IQR) pleura thickness in the moderate-to-severe BPD group was 1.7(1.6–1.85) mm, which was thicker than that in the none-to-mild BPD infants (P < 0.001), meanwhile the proportions of rough pleural lines, diffuse AIS, retrodiaphragmatic hyperechogenicity, small cysts above the diaphragm and rough diaphragm in the moderate-to-severe BPD group were also higher than those in none-to-mild BPD group (86.7% vs 36.5, 57.8% vs 7.9%, 37.8% vs 0, 33.3% vs 0, P < 0.001). In evaluating moderate-to-severe BPD, rough pleura had 91.1% (95% confidence interval [CI]: 0.793–0.965) in sensitivity, 91.3% (95% CI: 0.797–0.966) in negative predictive value (NPV), and 66.7% (95% CI: 0.544–0.771) in specificity. Small cysts had 100% (95% CI: 0.941-1) in specificity, 100% (95% CI: 0.816-1) in PPV, and 37.8% in sensitivity (95% CI: 0.251–0.524). Rough diaphragm had 100% (95% CI: 0.943-1) in sensitivity, 100% (95% CI: 0.796-1) in PPV and 33.3% (95% CI: 0.211–0.478) in specificity. CONCLUSIONS: Depending on its unique advantages such as convenient, no radiation and repeatable, LUS is a valuable imaging method in assessing the severity of BPD, especially in moderate and severe BPD.

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Follow-up at 15 Years of Preterm Infants From a Controlled Trial of Moderately Early Dexamethasone for the Prevention of Chronic Lung Disease

PEDIATRICS ◽

10.1542/peds.2004-0956 ◽

2005 ◽

Vol 115 (3) ◽

pp. 681-687 ◽

Cited By ~ 34

Author(s):

S. J. Gross

Keyword(s):

Lung Disease ◽

Preterm Infants ◽

Chronic Lung Disease ◽

Controlled Trial

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360 9 Years Follow up of Preterm Infants < or = 28 Weeks at Birth

Pediatric Research ◽

10.1203/00006450-200508000-00389 ◽

2005 ◽

Vol 58 (2) ◽

pp. 416-416

Author(s):

A Stephant ◽

E Basson ◽

L Sann ◽

G Putet

Keyword(s):

Preterm Infants

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Sex Differences in Rotary Pursuit Performance of Young Children: A Follow-up

Perceptual and Motor Skills ◽

10.2466/pms.1968.26.3c.1199 ◽

1968 ◽

Vol 26 (3_suppl) ◽

pp. 1199-1202 ◽

Cited By ~ 11

Author(s):

Stephen H. Davol ◽

Susan L. Breakell

Keyword(s):

Sex Differences ◽

Middle Class ◽

Young Children ◽

Grade Level ◽

Rest Period ◽

Lower Class ◽

Rotary Pursuit

A 30-rpm or a 45-rpm rotary pursuit task was given to 72 boys and 72 girls from Grades 1 to 5 of a lower-class and a middle-class school; each S was given 5 125-sec. trials with a 1-min. rest period between trials. Analyses of time-on-target showed a different pattern of results for each school. No significant sex differences were found except through interaction with sex of E. Level of performance was determined primarily by speed of rotation and grade level of S, but there was a lag in performance of Ss from the first two grades of the lower-class school.

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Intermittent Kangaroo Mother Care and the Practice of Breastfeeding Late Preterm Infants: Results from Four Hospitals in Different Provinces of China

10.21203/rs.2.18645/v2 ◽

2020 ◽

Author(s):

Bo Zhang ◽

Zhiying Duan ◽

Yingxi Zhao ◽

Sarah Williams ◽

Stephen Wall ◽

...

Keyword(s):

Breast Milk ◽

Preterm Infants ◽

Exclusive Breastfeeding ◽

Kangaroo Mother Care ◽

Late Preterm ◽

Feeding Practice ◽

Late Preterm Infants ◽

Breastfeeding Rate ◽

Milk Feeding

Abstract Background China has an extremely low exclusive breastfeeding rate. Kangaroo mother care (KMC) has been shown to increase the exclusive breastfeeding rate among infants born extremely or very preterm. However, there is limited evidence surrounding intermittent KMC and exclusive breastfeeding in late preterm infants. In our study we investigated the association between the provision of intermittent KMC and breastfeeding practice for late preterm infants in four hospitals in different provinces of China. Methods Intermittent KMC was recommended to the mothers of all preterm infants admitted to the postnatal wards of participating hospitals between March 2018 and March 2019. Those who agreed to practice KMC were enrolled in the “KMC group”, those who did not were enrolled in the “No KMC group”. Basic maternal socio-demographic information was collected, feeding practice; outcome and method, were recorded daily whilst in hospital. A follow-up survey of feeding practice was conducted 42 days after discharge. Calculations for feeding practice were performed separately for both groups. Logistics regression was used to analyze the association between KMC and feeding outcome and method, adjusting for socio-demographic covariates. Results Among the 844 mothers participating in the study, 627 (74.3%) chose to perform KMC. More of the mothers who provided KMC were exclusively breast milk feeding their infants in the 24 hours before hospital discharge (54.6%) and at follow-up (57.3%), compared to mothers who did not provide KMC (34.6% at discharge and 33.2% at follow-up,). Mothers in the KMC group were more likely to be breastfeeding (method) than mothers in the No KMC group (65.3% vs. 52.1% at discharge, and 83.1% vs. 67.3% at follow up). Logistic regression indicated that compared with the No KMC group, mothers who provided KMC were twice as likely to be exclusively breast milk feeding their infants at discharge (OR=2.15 (1.53-3.02)), use breastfeeding method at discharge as opposed to other means such as bottle or cup feeding (OR=1.61 (1.15-2.25)), be exclusive breast milk feeding at follow-up (OR=2.55 (1.81-3.61)), and use breastfeeding method at follow-up (OR=2.09 (1.44-3.02)). Conclusions Intermittent KMC was associated with a nearly doubled increase in exclusive breast milk feeding (outcome) and breastfeeding (method) at both discharge and 42 days after discharge for late preterm infants. This is especially important in China where exclusive breastfeeding rates are low, intermittent KMC provides a feasible means to increase the likelihood of these vulnerable infants receiving the benefits of exclusive breastmilk.

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