scholarly journals Early Detection of Cognitive, Language, and Motor Delays for Low-Income Preterm Infants: A Brazilian Cohort Longitudinal Study on Infant Neurodevelopment and Maternal Practice

2021 ◽  
Vol 12 ◽  
Author(s):  
Nadia C. Valentini ◽  
Luana S. de Borba ◽  
Carolina Panceri ◽  
Beth A. Smith ◽  
Renato S. Procianoy ◽  
...  
Keyword(s):  
Protective Factors ◽  
Preterm Infants ◽  
Infant Development ◽  
Adverse Outcomes ◽  
Late Preterm ◽  
Maternal Factors ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Infant Neurodevelopment ◽  
Composite Scores

Aim: This study examined the neurodevelopment trajectories, the prevalence of delays, and the risks and protective factors (adverse outcomes, environment, and maternal factors) associated with cognitive, motor, and language development for preterm infants from 4– to 24-months.Method: We assessed 186 preterm infants (24.7% extremely preterm; 54.8% very preterm; 20.4% moderate/late preterm) from 4– to 24-months using the Bayley Scales of Infant Development – III. Maternal practices and knowledge were assessed using the Daily Activities of Infant Scale and the Knowledge of Infant Development Inventory. Birth risks and adverse outcomes were obtained from infant medical profiles.Results: A high prevalence of delays was found; red flags for delays at 24-months were detected at 4– and 8-months of age. The neurodevelopmental trajectories showed steady scores across time for cognitive composite scores for extremely- and very-preterm infants and for language composite scores for the extremely- and moderate/late-preterm; a similar trend was observed for the motor trajectories of moderate/late preterm. Changes over time were restricted to motor composite scores for extremely- and very-preterm infants and for cognitive composite scores for moderate/late preterm; declines, stabilization, and improvements were observed longitudinally. Positive, strong, and significant correlations were for the neurodevelopment scores at the first year of life and later neurodevelopment at 18 and 24 months. The cognitive, language, and motor composite scores of extremely and very preterm groups were associated with more risk factors (adverse outcomes, environment, and maternal factors). However, for moderate/late preterm infants, only APGAR and maternal practices significantly explained the variance in neurodevelopment.Discussion: Although adverse outcomes were strongly associated with infant neurodevelopment, the environment and the parents’ engagement in play and breastfeeding were protective factors for most preterm infants. Intervention strategies for preterm infants should start at 4– to 8-months of age to prevent unwanted outcomes later in life.

Bradycardias are associated with more severe effects on cerebral oxygenation in very preterm infants than in late preterm infants

2018 ◽  
Vol 127 ◽  
pp. 33-41 ◽  
Author(s):  
Lisa M. Walter ◽  
Bushra Ahmed ◽  
Alexsandria Odoi ◽  
Hannah Cooney ◽  
Rosemary S.C. Horne ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Cerebral Oxygenation ◽  
Late Preterm ◽  
Very Preterm Infants ◽  
Late Preterm Infants ◽  
Very Preterm

Cerebral NIRS patterns in late preterm and very preterm infants becoming late preterm

2017 ◽  
Vol 32 (7) ◽  
pp. 1124-1129 ◽  
Author(s):  
Alice Grometto ◽  
Benedetta Pizzo ◽  
Maria Chiara Strozzi ◽  
Francesca Gazzolo ◽  
Diego Gazzolo
Keyword(s):  
Preterm Infants ◽  
Late Preterm ◽  
Very Preterm Infants ◽  
Very Preterm

scholarly journals 24 Association of location of intubation procedure and number of tracheal intubation attempts with death or severe neurological injury among very preterm infants

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e9-e9
Author(s):  
Anthony Debay ◽  
Sharina Patel ◽  
Pia Wintermark ◽  
Martine Claveau ◽  
François Olivier ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Preterm Infants ◽  
Physiological Stress ◽  
Periventricular Leukomalacia ◽  
Adverse Outcomes ◽  
Neurological Injury ◽  
Multivariable Logistic Regression Analysis ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Increased Risk

Abstract Background The physiological stress induced by tracheal intubation (TI) is associated with increased risk of neurological injury among very preterm infants. The location of TI procedure and number of attempts required may contribute to adverse outcomes. Objectives We aimed to assess the association of location where TI is performed and the number of TI attempts with death and/or severe neurological injury (SNI) among very preterm infants born <33 weeks and intubated in the first 7 days of life. Design/Methods Retrospective cohort study of 442 infants born 23-32 weeks gestation, admitted to a Level 3 NICU 2015-2018 within the first 7 days of life. We excluded infants who were moribund and the ones with a major congenital anomaly. Data was collected from the Canadian Neonatal Network database and chart review. Exposures were location of TI (delivery room [DR] vs. NICU) and number of TI attempts (1 vs. >1) among infants intubated in the first 7 days of life. Primary outcome was death and/or SNI (intraventricular hemorrhage grade 3-4 and/or periventricular leukomalacia). Multivariable logistic regression analysis was used to assess the association between exposures and outcomes and adjust for confounders. Results Rate of intubation was 46% (202/442). Rate of death and/or SNI was 2.5% (6/240) among infants never intubated, 12% (13/105) among NICU TI, 32% (31/97) among DR TI, 20% (17/85) among infants with 1 TI attempt and 23% (27/117) among infants with >1 TI attempt. Rate of premedication use for NICU TI was 97% (102/105). Overall, median number of intubation attempts was 1 [IQR 1-2]. Compared to no TI, TI in the NICU (adjusted odds ratio [AOR] 3.39, 95% CI 1.20-10.53) and TI in the DR (AOR 9.28, 95% CI 3.33-29.43) were associated with higher odds of death and/or SNI. DR TI was associated with higher odds of death and/or SNI compared to NICU TI (AOR 2.73, 95% CI 1.23-6.35). Compared to no TI, 1 TI attempt (AOR 5.25, 95% CI 1.93-15.93) and >1 TI attempt (AOR 5.17, 95% CI 1.93-15.69) were associated with higher odds of death and/or SNI. The number of intubation attempts (1 vs. >1) was not associated with death and/or SNI (AOR 0.99, 95% CI 0.47-2.09). Conclusion Intubated infants have higher odds of death and/or SNI. Among intubated infants, DR TI is associated with higher odds of death and/or SNI vs. TI in the NICU with premedication. Optimizing non-invasive ventilation in the DR may help reduce brain injury in preterm infants.

scholarly journals Perinatal Risk and Protective Factors in the Development of Diffuse White Matter Abnormality on Term-Equivalent Age MRI in Infants Born Very Preterm

2020 ◽  
Author(s):  
Nehal A Parikh ◽  
Puneet Sharma ◽  
Lili He ◽  
Hailong Li ◽  
Mekibib Altaye ◽  
...  
Keyword(s):  
White Matter ◽  
Protective Factors ◽  
Preterm Infants ◽  
Brain Mri ◽  
White Matter Abnormality ◽  
Maternal Milk ◽  
Very Preterm Infants ◽  
Equivalent Age ◽  
Very Preterm ◽  
Diffuse White Matter

Importance: Diffuse white matter abnormality (DWMA) is the most common brain MRI finding in very preterm infants and is predictive of neurodevelopmental impairments. However, its etiology remains elusive and identifying perinatal risk and protective factors may allow clinicians to reduce the burden of DWMA. Objective: To identify perinatal clinical factors that are associated with the development of objectively diagnosed DWMA in very preterm infants. Design: A prospective cohort was enrolled between September 2016 and November 2019. Brain MRIs were collected at 39 to 45 weeks postmenstrual age (PMA) to evaluate DWMA volume. A pre-defined list of pertinent maternal characteristics, pregnancy/delivery data, and neonatal ICU data was collected for enrolled patients to identify antecedents of objectively diagnosed DWMA. Setting: Five level III/IV NICUs in the greater Cincinnati, Ohio area. Participants: A population-based sample of 392 very preterm infants born before 33 weeks gestational age. Exposure: Very preterm birth with associated diseases and treatments. Main Outcome and Measure: Objectively diagnosed DWMA volume on brain MRI at term-equivalent age. Results: 377 of the 392 very preterm infants (96%) had high quality MRI data. Mean (SD) gestational age was 29.3 (2.5) weeks. In multivariable linear regression analyses, pneumothorax (p=.027), severe bronchopulmonary dysplasia (BPD) (p=.009), severe retinopathy of prematurity (ROP) (p<0.001), and male sex (p=.041) were associated with increasing volume of DWMA. The following factors were associated with decreased risk of DWMA: dexamethasone for severe BPD (p=.004), duration of caffeine for severe BPD (p = 0.009), and exclusive maternal milk at NICU discharge (p=.049). Conclusions and Relevance: Severe ROP and BPD exhibited the strongest adverse association with the development of DWMA. Caffeine and dexamethasone treatments for infants with severe BPD exhibited a protective effect against development of DWMA. The beneficial association with maternal milk is also a modifiable factor that has clinical implications.

Prescriptive birthweight charts can improve the prediction of adverse outcomes in very preterm infants who are small for gestational age

2018 ◽  
Vol 107 (6) ◽  
pp. 981-989 ◽  
Author(s):  
Liset Hoftiezer ◽  
Renske G. Snijders ◽  
Chantal W.P.M. Hukkelhoven ◽  
Richard A. van Lingen ◽  
Marije Hogeveen
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Adverse Outcomes ◽  
Very Preterm Infants ◽  
Very Preterm

scholarly journals 2902. Pertussis Antibody Levels in Preterm Infants After Maternal Tdap Immunization During Pregnancy

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S83-S83
Author(s):  
C Mary Healy ◽  
Marcia Rench ◽  
Laurie Swaim ◽  
Gowrisankar Rajam ◽  
Fiona Havers ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Geometric Mean ◽  
Late Preterm ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Luminex Assay ◽  
Very Preterm ◽  
Maternal Immunization ◽  
Specific Igg ◽  
Antibody Levels

Abstract Background Maternal immunization with tetanus, diphtheria, acellular pertussis vaccine (Tdap) in the third trimester reduces infant pertussis, but data are lacking on how this strategy impacts pertussis antibody levels in large cohorts of preterm infants Methods We collected paired maternal delivery-cord sera from infants of women who received Tdap ≥7 days before birth. IgG to pertussis toxin (PT), filamentous hemagglutinin (FHA), fimbrial proteins (FIM) and pertactin (PRN) was quantified by Luminex assay (IU/mL). Geometric mean concentrations (GMC) with 95% confidence intervals (CI) for pertussis antibodies were calculated. Four infant groups were compared by weeks of gestation: very (<32), moderate (32–33) and late preterm (34–36), and term (≥37). Results 344 preterm and 688 term mother-infant pairs were included. Among preterm infants, mean maternal age was 31.2 years (range 15.1–39.3); 37% were white, 37% Hispanic, 17% Black, 8% Asian and 1% other. Fifty-six were very preterm infants (16%, mean gestation 30.5 weeks), 82 moderate (24%, 33.1 weeks), and 206 late (60%, 35.4 weeks); 17 (5%) were born at <30 weeks. For preterm infants, Tdap was administered at a mean gestation of 29.9 weeks (very 27.9; moderate 29.7; late 30.4; [P < .001]), and at a mean interval of 29.3 days before delivery (very 17.9; moderate 24; late 34.5 [P <.001]). Eleven (3%) women received Tdap during the second trimester (8 very, 2 moderate, 1 late). GMCs (95% CI) of pertussis-specific IgG at birth varied by gestation (table). Infant antibody levels as a proportion of maternal antibodies increased from 24 to 32% in infants < 30 weeks to 117 to 132% in those ≥37 weeks (P<.001). Conclusion Although levels are lower than in term infants, maternal immunization with Tdap results in substantial pertussis-specific antibodies in most preterm infants, especially late preterm infants. Disclosures All Authors: No reported Disclosures.

Comparison of Enrollment in Interventional Therapies Between Late-Preterm and Very Preterm Infants at 12 Months' Corrected Age

PEDIATRICS ◽  
2009 ◽  
Vol 123 (3) ◽  
pp. 804-809 ◽  
Author(s):  
J. L. Kalia ◽  
P. Visintainer ◽  
H. L. Brumberg ◽  
M. Pici ◽  
J. Kase
Keyword(s):  
Preterm Infants ◽  
Late Preterm ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Interventional Therapies

scholarly journals Effect of Family-centered Care Interventions on Motor and Neurobehavior Development of Very Preterm Infants: A Protocol of Systematic Review

2020 ◽  
Author(s):  
Manasa Kolibylu Raghupathy ◽  
Bhamini Krishna Rao ◽  
Shubha R Nayak ◽  
Alicia J Spittle ◽  
Shradha S Parsekar
Keyword(s):  
Systematic Review ◽  
Preterm Infants ◽  
Infant Development ◽  
Data Extraction ◽  
Meta Analysis ◽  
Health Concern ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Very Preterm Infants ◽  
Very Preterm

Abstract Background: Globally, preterm birth is a health concern leading to various developmental difficulties such as poor motor and/or cognitive function. For infants born preterm, FCC promotes developmental skills over the time in an appropriate enriched environment. The purpose of this study is to systematically review and assess the evidence of FCC interventions on motor and neurobehavioral development in very preterm infants. Additionally, this review aims to determine the factors that might affect the infant development.Methods: Systematic review will be carried out by including quasi-experimental controlled trials and randomized controlled trials. Electronic databases such as Scopus, PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, and PsycINFO will be searched using database specific terms. Additionally, searches will be carried out in ProQuest, and references of included studies will be searched. Two review authors, independently, will conduct the screening, data extraction, and critical appraisal of included studies. If possible, meta-analysis will be undertaken to assess the effect of FCC on motor and neurobehavior of premature infants.Conclusion: The review will provide insights regarding the effect of the FCC on preterm infants. This systematic review will guide the clinicians on the feasibility of practicing FCC that might support and promote the integration of parents into various rehabilitation settings.Systematic review registration: Protocol has been submitted to PROSPERO on July 26, 2020.

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