scholarly journals Pulmonary Outcomes in Children Born Extremely and Very Preterm at 11 Years of Age

2021 ◽  
Vol 9 ◽  
Author(s):  
Paola Di Filippo ◽  
Cosimo Giannini ◽  
Marina Attanasi ◽  
Giulia Dodi ◽  
Alessandra Scaparrotta ◽  
...  
Keyword(s):  
Lung Function ◽  
Gestational Age ◽  
Blood Count ◽  
Positive Association ◽  
Diffusing Capacity ◽  
Preterm Children ◽  
Prick Test ◽  
Very Preterm ◽  
Preterm Group ◽  
Respiratory Outcomes

Background: There is increasing evidence of prematurity being a risk factor for long-term respiratory outcomes regardless the presence of bronchopulmonary dysplasia (BPD).Aim: To assess the effect of prematurity on respiratory outcomes in children born ≤32 weeks of gestational age at 11 years of age.Materials and Methods: Fifty five ex-preterm children (≤ 32 weeks of gestational age), born in Chieti between January 1, 2006 and December 31, 2007, performed lung function and diffusing capacity test (DLCO) at 11 years of age. Furthermore, allergy evaluation by skin prick test (SPT), eosinophil blood count and assessment of eosinophilic airways inflammation by exhaled nitric oxide (FeNO) were performed. The ex-preterm group was compared to an age- and sex-matched group of term children.Results: No difference for atopic and respiratory medical history was found between ex-preterm children and term controls, except for preschool wheezing that resulted more frequent in ex-preterm children. No difference neither in school-aged asthma frequency nor in lung function assessment at 11 years of age was found between the two groups. Lower DLCO values in ex-preterm children compared to term controls regardless the presence of BPD were found; furthermore, we showed a positive association between DLCO and gestational age. Eosinophil blood count, positive SPTs and FeNO values were similar between the two groups.Conclusions: Diffusing lung capacity was decreased in ex-preterm children at 11 years of age in the absence of lung function impairment and eosinophil airway inflammation, suggesting a non-eosinophilic pattern underlying pulmonary alterations. It could be desirable to include the diffusing capacity assessment in follow-up evaluation of all ex-preterm children.

scholarly journals The Association between Asthma and Obesity in Children – Inflammatory and Mechanical Factors

2019 ◽  
Vol 7 (8) ◽  
pp. 1314-1319 ◽  
Author(s):  
Valentina Cvejoska-Cholakovska ◽  
Mirjana Kocova ◽  
Vesna Velikj-Stefanovska ◽  
Emilija Vlashki
Keyword(s):  
Lung Function ◽  
Inflammatory Markers ◽  
High Body Mass Index ◽  
Positive Association ◽  
Total Serum ◽  
Prick Test ◽  
Asthmatic Patients ◽  
Significant Difference ◽  
Underlying Mechanisms ◽  
Obesity In Children

BACKGROUND: Association of asthma and obesity has been demonstrated in numerous epidemiological studies. However, the underlying mechanisms of the association are not well understood. Both conditions are characterised by chronic tissue inflammation, which includes numerous different inflammatory markers, and possible atopy. AIM: The study aimed to investigate the association between asthma and obesity in children and assess several of potential underlying mechanisms, including the parameters of systemic inflammation (CRP, fibrinogen) and the mechanical effect of obesity on the respiratory system through parameters of lung function. An additional aim was to examine the role of atopy in overweight children with asthma and to investigate the type of respiratory inflammation. MATERIAL AND METHODS: This prospective study included 72 patients in the age group of 7-15 years, including 38 with high body mass index (BMI), 16 with asthma and normal BMI, and 18 with asthma and high BMI for sex and age. Non-specific inflammatory markers (fibrinogen, CRP), eosinophilia, and total serum IgE were investigated. The patients underwent a skin prick test (SPT) with standard inhalant allergen extracts, measurement of fractional exhaled nitric oxide Fe (NO), and an assessment of lung function. RESULTS: In overweight groups of children we determined significantly higher values (p < 0.001) of both acute inflammatory reactants, CRP and fibrinogen, with no difference between children with and without asthma. There was a significant increase in eosinophilia, total IgE, and positive SPT in the asthmatic groups compared to the group of non-asthmatic patients (p < 0.001 for the three parameters). Compared to the group composed of overweight patients without asthma, the asthmatic patients had higher NO values (p < 0.001). No significant difference in the lung function parameters was found between the three groups (p > 0.05). CONCLUSION: A positive association between asthma and obesity with inflammation as an underlying mechanism, eosinophilic one in asthmatic patients and non-eosinophilic one in overweight patients, was determined. It seems that the lung function parameters did not differ between asthmatic patients and overweight patients. No influence of atopy in the association between asthma and obesity was verified. Further analyses of specific inflammatory markers, for an in-depth evaluation of the mechanisms leading to the association of obesity and asthma, are warranted.

scholarly journals Quantitative Assessment of Nutritive Sucking Patterns in Preterm Infants (P11-095-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ariel Salas ◽  
Claire Meads ◽  
Shae Ganus ◽  
Anisha Bhatia ◽  
Caitlin Taylor ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Quantitative Assessment ◽  
Positive Association ◽  
Oral Feeding ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Nutritive Sucking ◽  
Improve Determination

Abstract Objectives Mastery of oral feeding independent of supplementary feeding tubes is crucial for safe discharge of very preterm infants (≤ 32 weeks of gestation). Qualitative assessments of suck-swallow-breathe coordination can be subjective and result in prolonged hospitalizations and delay discharges. Quantitative assessment of sucking activity during feeding (i.e., nutritive sucking) could improve determination of readiness for progression to independent oral feeding and facilitate discharge planning. To quantitively assess nutritive sucking patterns using an instrumented feeding bottle. Methods Preterm infants ≤ 32 weeks of gestation who attained independent oral feeding were prospectively evaluated after written informed consent was obtained. Infants with congenital anomalies and infants with major comorbidities were excluded. Nutritive sucking was assessed for a minimum of one feeding session in each participant by instrumenting a commercially available feeding bottle with a detachable pressure sensor configured to detect changes in the bottle enclosure. Speech pathologists administered the feeding using a standardized technique with infants under continuous cardiorespiratory monitoring. Type of feed, volume, and schedule was maintained consistently in accordance with each participant's defined regimen during his/her hospitalization. Results We analyzed 63 feeding sessions from 33 preterm infants. Mean birthweight of study participants was 1160 g (SD: 455) and median gestational age was 28 weeks (IQR: 27 – 31). Nutritive sucking patterns were assessed at term equivalent age (median corrected gestational age: 37 weeks; IQR: 35 – 39). During each feeding session, the median suck count was 784 (IQR: 550 – 1053), the median sucking rate was 0.6/s (IQR: 0.5 -0.9), the median number of brief feeding interruptions was 10 (IQR: 6–15), and the median value of sucking bursts was 52 (41-65) [Image]. Maximum suck strength strongly correlated with suck count (r = 0.68). A positive association between suck count and sucking bursts was found in unadjusted regression models (R2 = 0.35; P < 0.0001) and models adjusted for gestational age at birth, birthweight, feeding volume, transient events during feeding, and postnatal age (R2 = 0.50; P < 0.0001). Conclusions In stable very preterm infants, nutritive sucking patterns can be quantified by instrumentation of commercially available feeding bottles. Further analyses of sucking burst patterns may improve determination of readiness for progression to independent oral feeding in preterm infants. Funding Sources None. Supporting Tables, Images and/or Graphs

scholarly journals Craniofacial Morphology in Prematurely Born Children

2009 ◽  
Vol 79 (2) ◽  
pp. 276-283 ◽  
Author(s):  
Liselotte Paulsson ◽  
Lars Bondemark
Keyword(s):  
Head Circumference ◽  
Null Hypothesis ◽  
Full Term ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Preterm Children ◽  
Very Preterm ◽  
Anterior Cranial Base ◽  
Extremely Preterm ◽  
Preterm Group

Abstract Objective: To test the null hypothesis that there is no difference between the craniofacial morphology of prematurely born children and that of matched full-term born controls. Materials and Methods: White children 8 to 10 years of age, born at the University Hospitals of Lund and Malmö and living in the same part of Sweden, were included. One group consisted of 36 very preterm children, born during gestational weeks 29 to 32; the other group included 36 extremely preterm children, who were born before the 29th gestational week. Subjects were compared with a control group of 31 full-term children, who were matched for gender, age, nationality, and living area. One lateral head radiograph was taken for each child, and the cephalometric analysis included 15 angular and 11 linear variables. Also, the height, weight, and head circumference of each child were registered. Results: A significantly shorter anterior cranial base and a less convex skeletal profile were found among extremely preterm children, and significantly shorter maxillary length was noted in both extremely preterm and very preterm groups as compared with full-term children. The lower incisors were significantly more retroclined and retruded in the extremely preterm group compared with the very preterm group and the full-term control group. Extremely preterm children were significantly shorter, and both extremely preterm and very preterm children had significantly lower weight and smaller head circumference compared with full-term children. Conclusion: The null hypothesis was rejected because several craniofacial parameters differed significantly between preterm and full-term born control children.

Voice problems in school-aged children following very preterm birth

2016 ◽  
Vol 101 (6) ◽  
pp. 556-560 ◽  
Author(s):  
Victoria Reynolds ◽  
Suzanne Meldrum ◽  
Karen Simmer ◽  
Shyan Vijayasekaran ◽  
Noel French
Keyword(s):  
Gestational Age ◽  
Very Low Birth Weight ◽  
Retrospective Chart Review ◽  
Female Gender ◽  
Preterm Children ◽  
Very Preterm ◽  
Extremely Preterm ◽  
Speech Pathologist ◽  
Registration Number ◽  
Study Participants

Background and objectiveVery preterm children may be at risk of voice abnormalities (dysphonia). Risk factors previously identified in extremely preterm children include female gender, multiple intubations, complicated intubation and very low birth weight. This study sought to identify the prevalence of dysphonia in very preterm children, at school age.MethodsChildren born between 23 and 32 weeks’ gestation were included in this prospective observational study. Participants were randomly selected from a sample stratified by gestational age and number of intubations, and were aged between 5 and 12 years at the time of assessment. Clinical voice assessments were conducted by a speech pathologist, and a diagnosis of dysphonia was made based on the presence and severity of disturbance to the voice. Retrospective chart review identified medical and demographic characteristics.Results178 participants were assessed. The prevalence of dysphonia in this cohort was 61%. 31% presenting with significant dysphonia, that is, voice disturbance of greater than mild in severity. Female gender (p=0.009), gestational age (p=0.031) and duration of intubation (p=0.021) were significantly associated with dysphonia although some preterm children with dysphonia were never intubated.ConclusionsSignificant voice abnormalities were observed in children born at up to 32 weeks’ gestation, with intubation a major contributing factor.Trial registration numberACTRN12613001015730.

scholarly journals Attentional networks efficiency in preterm children

2009 ◽  
Vol 16 (1) ◽  
pp. 130-137 ◽  
Author(s):  
R. PIZZO ◽  
S. URBEN ◽  
M. VAN DER LINDEN ◽  
C. BORRADORI-TOLSA ◽  
M. FRESCHI ◽  
...  
Keyword(s):  
Gestational Age ◽  
Executive Control ◽  
Full Term ◽  
Preterm Children ◽  
Attention Network ◽  
Attentional Deficits ◽  
Control Networks ◽  
Attentional Networks ◽  
Preterm Group

AbstractRecent studies have reported specific executive and attentional deficits in preterm children. However, the majority of this research has used multidetermined tasks to assess these abilities, and the interpretation of the results lacks an explicit theoretical backdrop to better understand the origin of the difficulties observed. In the present study, we used the Child Attention Network Task (Child ANT; Rueda et al. 2004) to assess the efficiency of the alerting, orienting and executive control networks. We compared the performance of 25 preterm children (gestational age ≤ 32 weeks) to 25 full-term children, all between 5½ and 6½ years of age. Results showed that, as compared to full-term children, preterm children were slower on all conditions of the Child ANT and had a specific deficit in executive control abilities. We also observed a significantly higher correlation between the orienting and executive control networks in the preterm group, suggesting less differentiation of these two networks in this population. (JINS, 2010, 16, 130–137.)

Temporal Trends of Acute Kidney Injury and Associated Risk Exposures in Extremely Preterm Infants

2021 ◽  
pp. CJN.19301220
Author(s):  
Chih-Chia Chen ◽  
Yung-Chieh Lin ◽  
Shan-Tair Wang ◽  
Chao-Ching Huang ◽  
Keyword(s):  
Serum Creatinine ◽  
Preterm Infants ◽  
Gestational Age ◽  
Temporal Trends ◽  
Content Type ◽  
Very Preterm ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Preterm Group ◽  
Care Practices

Background and objectivesNeonatal AKI in the preterm population is an under-recognized morbidity. Detecting AKI in preterm infants is important for their long-term kidney health. We aimed to examine the yearly trends of incidence and the related morbidities and care practices affecting the occurrence of neonatal AKI in extremely preterm (gestational age <29 weeks) and very preterm (gestational age 29–32 weeks) infants.Design, setting, participants, & measurementsThe trends and the related risk factors and care practices of AKI were examined in the extremely preterm (n=434) and very preterm (n=257) infants who were admitted within 14 days after birth from 2005 to 2018 to the University Hospital and had at least two serum creatinine measurements during hospitalization. We defined AKI as a serum creatinine rise of 0.3 mg/dl or more within 48 hours or a 1.5-fold increase within 7 days.ResultsThe extremely preterm group had a three-fold higher incidence of AKI (30% versus 10%) than the very preterm group. Among preterm infants with AKI, 92% had one episode of AKI, and 45% experienced stage 2 or 3 AKI; the mean duration of AKI was 12±9 days. Across the 14-year period, the crude incidence of AKI declined markedly from 56% to 17% in the extremely preterm group and from 23% to 6% in the very preterm group. After adjustment, a significant decline of AKI incidence was still observed in the extremely preterm group. The declining AKI in the extremely preterm infants was related to the trends of decreasing incidences of neonatal transfer, prolonged aminoglycoside exposure, prophylactic use of nonsteroidal anti-inflammatory drugs, and sepsis.ConclusionsWe observed a declining trend in the incidence of neonatal AKI among extremely preterm infants from 2005 to 2018, which may be related to improvement of care practices.

scholarly journals Hypertensive disorders of pregnancy, respiratory outcomes and atopy in childhood

2015 ◽  
Vol 47 (1) ◽  
pp. 156-165 ◽  
Author(s):  
Seif O. Shaheen ◽  
Corrie Macdonald-Wallis ◽  
Debbie A. Lawlor ◽  
A. John Henderson
Keyword(s):  
Risk Factor ◽  
Lung Function ◽  
Gestational Hypertension ◽  
Positive Association ◽  
Epidemiological Studies ◽  
Forced Expiratory Volume ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Parents And Children ◽  
Respiratory Outcomes

Few epidemiological studies have investigated the role of hypertensive disorders of pregnancy in the aetiology of childhood respiratory and atopic outcomes.In the Avon Longitudinal Study of Parents and Children we examined associations of maternal gestational hypertension, hypertension before pregnancy and pre-eclampsia with wheezing at 18 months, wheezing and asthma at 7 years and lung function at 8–9 years, after controlling for potential confounders (n=5322–8734, depending on outcome).Gestational hypertension was not associated with any of the outcomes. There was weak evidence for a positive association between pre-eclampsia and early wheezing (adjusted OR 1.31, 95% CI 0.94–1.82, compared to normotensive pregnancies) and for negative associations between pre-eclampsia and forced expiratory volume in 1 s (adjusted mean difference in sd score −0.14, 95% CI −0.33–0.06) and maximal mid-expiratory flow (−0.15, 95% CI −0.34–0.04). Hypertension before pregnancy was positively associated with wheezing (OR 1.63, 95% CI 1.16–2.31) and asthma (OR 1.34, 95% CI 1.00–1.79).Gestational hypertension is unlikely to be a risk factor for childhood respiratory disorders; hypertension before pregnancy may be a risk factor for childhood wheezing and asthma, but this finding needs replication. Larger studies are needed to confirm whether pre-eclampsia is associated with impaired childhood lung function.

scholarly journals The Course Of IGF-1 Levels and Nutrient Intake in Extremely and Very Preterm Infants During Hospitalisation

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 675
Author(s):  
Dana F.J. Yumani ◽  
Alexandra K. Calor ◽  
Mirjam. M. van Weissenbruch
Keyword(s):  
Parenteral Nutrition ◽  
Preterm Infants ◽  
Gestational Age ◽  
Nutrient Intake ◽  
Positive Association ◽  
Time Frame ◽  
Future Research ◽  
Macronutrient Intake ◽  
Very Preterm Infants ◽  
Very Preterm

Background: Insulin-like growth factor 1 (IGF-1) plays an important role in the complex association between nutrition, growth, and maturation in extremely and very preterm infants. Nevertheless, in this population, research on associations between IGF-1 and nutrition is limited. Therefore this study aimed to evaluate the possible associations between the course of IGF-1 levels and nutrient intake between preterm birth and 36 weeks postmenstrual age (PMA). Methods: 87 infants born between 24 and 32 weeks gestational age were followed up to 36 weeks PMA. Actual daily macronutrient intake was calculated, and growth was assessed weekly. IGF-1 was sampled from umbilical cord blood at birth and every other week thereafter. Results: There was an inverse relationship between the amount of parenteral nutrition in the second week of life and IGF-1. Total protein, fat, and carbohydrate intake, as well as total energy intake, primarily showed a positive association with IGF-1 levels, particularly between 30 and 33 weeks PMA. Gestational age, bronchopulmonary dysplasia (BPD), and weight were significant confounders in the association between nutrient intake and IGF-1 levels. Conclusion: Parenteral nutrition was found to be a negative predictor of IGF-1 levels, and there could potentially be a time frame in which macronutrient intake is unable to impact IGF-1 levels. Future research should aim to narrow down this time frame and to gain more insight into factors enhancing or decreasing the response of IGF-1 to nutrition, e.g., age and inflammatory state, to align nutritional interventions accordingly.

scholarly journals Early precursors of low attention and hyperactivity in moderately and very preterm children at preschool age

2013 ◽  
Vol 5 (4) ◽  
pp. 18 ◽  
Author(s):  
M. Regina Morales ◽  
Concetta Polizzi ◽  
Giorgio Sulliotti ◽  
Claudia Mascolino ◽  
Giovanna Perricone
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Two Dimensions ◽  
Full Term ◽  
Preschool Age ◽  
Preterm Children ◽  
Very Preterm ◽  
Significant Difference ◽  
Moderately Preterm

The low attention and hyperactivity are major morbidities associated with very and moderately preterm birth. The study has been aimed at investigating the likely occurrence of early precursors of Attention Deficit and Hyperactivity Disorder (ADHD) in very and moderately preterm children at preschool age. The involved children were: 25 very preterm children (M=29.4 weeks of gestational age, SD=2), with low birth weight (M=1200 g, SD=250 g); 35 moderately preterm children (M=34.6 weeks of gestational age, SD=1) with low birth weight (M=2100 g, SD=250 g); 60 healthy full-term children as the control group. Parents of children have been administered specific questionnaires to detect low attention and hyperactivity of their children at home. The data have shown the risk of precursors of ADHD, highlighting statistically significant birth-related differences in both hyperactivity/impulsivity [F(2,119)=3.5, P=0.03, η2=0.06] and inattention [F(2,119)=2.4, P=0.04, η2=0.04], where very preterm children have got higher scores in these two dimensions compared with full-term and moderately preterm children. The very preterm children have got higher scores of <em>impulsivity</em> and <em>inattention</em> than the full-term children (Tukey’HSD − Honestly Significant Difference; P&lt;0.001).

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