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

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<0.001).

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Strabismus in very low birth weight and/or very preterm children: Discrepancy between age of onset and start of treatment

European Journal of Pediatrics ◽

10.1007/bf01954277 ◽

1995 ◽

Vol 154 (3) ◽

pp. 225-229 ◽

Cited By ~ 7

Author(s):

J. W. R. Pott ◽

J. Van Hof-van Duin ◽

I. J. Heersema ◽

W. P. F. Fetter ◽

A. M. Schreuder ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Age Of Onset ◽

Preterm Children ◽

Very Preterm

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Effect of early and delayed cord clamping on hemoglobin and hematocrit among full term neonates.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.08.5574 ◽

2021 ◽

Vol 28 (08) ◽

pp. 1114-1119

Author(s):

Saqib Aslam ◽

◽

Sadaf Minhas ◽

Muhammad Azhar Farooq ◽

Beenish Bashir Mughal ◽

...

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Full Term ◽

P Value ◽

Delayed Cord Clamping ◽

Term Neonates ◽

Cord Clamping ◽

Significant Difference ◽

Early Cord Clamping ◽

The Mean

Objective: To compare the mean hemoglobin levels and frequency of polycythemia in full term neonates after early and delayed cord clamping. Study Design: Randomized Controlled Trial. Setting: KRL General Hospital Islamabad (Labor Room/ Neonatology). Periods: December 2017 to June 2018. Material & Methods: 190 full term neonates were selected and divided into 2 equal groups randomly: Early cord clamping group after delivery and late cord clamping group. Two hours after clamping the venous blood samples were taken for the hemoglobin and hematocrit levels. Mean and standard deviation were calculated for gestational age, birth weight, hemoglobin and hematocrit. Frequency and proportions were calculated for gender and polycythemia. Results: Mean gestational age of the mothers was 39.27 ± 1.50 weeks. Of 190 neonates, 91 (47.9%) were males, 99 (52.1%) were females. Mean birth weight was 3.64 ± 0.72 kg while mean Hb and HCT levels were 16.07 ± 2.30 g/dl and 63.26 ± 5.32% respectively. Keeping cut off value of 13.5 g/dl of Hb to label anemia or no, 35 (18.4%) neonates were anemic in this study. The polycythemia (HCT >65%) was present in 72 (37.9%) of neonates. There was no difference between groups in terms of gender, anemia, gestational age and birth weight (p values 0.663, 0.852, 0.700 and 0.491 respectively). The distribution of polycythemia was different among groups (p value 0.007). The mean hemoglobin level in group A was 15.52 ± 1.90 g/dl while in group B it was 16.62 ± 2.53 g/dl (p value 0.001). Mean Hb levels were statistically not different among some of the groups (gestational age <40 weeks, birth weight <4 kg) while HCT levels are significantly different among male group and category of birth weight >4 kg. Rest of the stratification groups showed significant difference. Conclusion: The delayed cord clamping in neonates results in increased mean hemoglobin and hematocrit levels with increased frequency of polycythemia as compared to early cord clamping.

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Synbiotics use for preventing sepsis and necrotizing enterocolitis in very low birth weight neonates: a randomized controlled trial

Clinical and Experimental Pediatrics ◽

10.3345/cep.2019.00381 ◽

2020 ◽

Vol 63 (6) ◽

pp. 226-231 ◽

Cited By ~ 1

Author(s):

Ozge Serce Pehlevan ◽

Derya Benzer ◽

Tugba Gursoy ◽

Guner Karatekin ◽

Fahri Ovali

Keyword(s):

Randomized Controlled Trial ◽

Birth Weight ◽

Low Birth Weight ◽

Necrotizing Enterocolitis ◽

Gestational Age ◽

Very Low Birth Weight ◽

Late Onset ◽

Controlled Trial ◽

Randomized Controlled ◽

Significant Difference

Background: Probiotics and prebiotics have strain-specific effects on the host. Synbiotics, a mixture of probiotics and prebiotics, are proposed to have more beneficial effects on the host than either agent has alone.Purpose: We performed a randomized controlled trial to investigate the effect of Lactobacillus and Bifidobacterium together with oligosaccharides and lactoferrin on the development of necrotizing enterocolitis (NEC) or sepsis in very low birth weight neonates.Methods: Neonates with a gestational age ≤32 weeks and birth weight ≤1,500 g were enrolled. The study group received a combination of synbiotics and lactoferrin, whereas the control group received 1 mL of distilled water as placebo starting with the first feed until discharge. The outcome measures were the incidence of NEC stage ≥2 or late-onset cultureproven sepsis and NEC stage ≥2 or death.Results: Mean birth weight and gestational age of the study (n=104) and the control (n=104) groups were 1,197±235 g vs. 1,151±269 g and 29±1.9 vs. 28±2.2 weeks, respectively (P>0.05). Neither the incidence of NEC stage ≥2 or death, nor the incidence of NEC stage ≥2 or late-onset culture-proven sepsis differed between the study and control groups (5.8% vs. 5.9%, P=1; 26% vs. 21.2%, P=0.51). The only significant difference was the incidence of all stages of NEC (1.9% vs. 10.6%, P=0.019).Conclusion: The combination of synbiotics and lactoferrin did not reduce NEC severity, sepsis, or mortality.

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Cognitive and behavioral status of low birth weight preterm children raised in a developing country at preschool age

Jornal de Pediatria ◽

10.2223/jped.1859 ◽

2009 ◽

Vol 0 (0) ◽

Cited By ~ 2

Author(s):

Júlia L. do Espírito Santo ◽

Mirna W. Portuguez ◽

Magda L. Nunes

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Developing Country ◽

Preschool Age ◽

Preterm Children

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Do emissions from landfill fires affect pregnancy outcomes? A retrospective study after arson at a solid waste facility in Sicily

BMJ Open ◽

10.1136/bmjopen-2018-027912 ◽

2019 ◽

Vol 9 (7) ◽

pp. e027912 ◽

Cited By ~ 2

Author(s):

Walter Mazzucco ◽

Elisa Tavormina ◽

Maurizio Macaluso ◽

Claudia Marotta ◽

Rosanna Cusimano ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Maternal Age ◽

Very Low Birth Weight ◽

Reference Group ◽

Study Group ◽

Live Births ◽

Very Preterm ◽

Infant Gender

ObjectivesIn response to public health concern about effects of arson at solid waste management plants in July 2012, we analysed vital statistics data to evaluate any potential effect on pregnancies at different gestational ages of pollutants emitted from the landfill on fire.SettingA community living near the largest landfill plant in Sicily.ParticipantsThe study group comprised 551 births, live births and stillbirths from pregnancies of mothers residing in the extra-urban exposed area, conceived during a 40 week period during which the highest fire’s peak might have influenced pregnancy.Primary and secondary outcome measuresBirth outcomes (gestational age <37 and <32 weeks, low birth weight, very low birth weight and small for gestational age) in the study group were compared with the ones of a reference group of women residing in areas of Sicily with similarly low population density and industrial development.ResultsAmong singleton live births we observed a three-fold increase in risk of very preterm birth between the extra-urban area and the remaining low inhabitants density and unindustrialised areas for births whose pregnancies were in the third trimester (OR adjusted for maternal age and infant gender=3.41; 95% CI 1.04 to 11.16). There was an excess of very low birth weight singleton infants in the study group as compared with the reference group, which was limited to births to mothers exposed during periconception period (OR adjusted for maternal age and infant gender=4.64; 95% CI 1.04 to 20.6) and first trimester (OR adjusted for maternal age and infant gender=3.66; 95% CI 1.11 to 12.1). The association estimates were imprecise due to the small number of outcomes recorded.ConclusionsThe study documented an excess of very preterm and very low birth weight among infants born to mothers exposed to the landfill fire emissions during conception or early pregnancy.

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Antenatal Azithromycin to Prevent Preterm Birth in Pregnant women with Vaginal Cerclage. A Randomized Controlled Trial

QJM ◽

10.1093/qjmed/hcab115.037 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Rania Hassan Mostafa ◽

Sherif Ahmed Ashoush ◽

Hassan Awwad Bayoumy ◽

Wessam Kamal Lotfy Gabr

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Antenatal Care ◽

Gestational Age ◽

Mode Of Delivery ◽

Perinatal Morbidity ◽

Randomized Controlled ◽

Significant Difference ◽

Gestational Age At Delivery

Abstract Background Preterm birth with its complications is one of the leading causes of perinatal morbidity and mortality, as well as maternal morbidity, especially in low and middle-income countries. Cervical cerclage is a well-established preventive tool in women at high risk of preterm birth; however, subclinical maternal infection might still cause failure of this method. Thus, adding prophylactic antibiotics, namely macrolides, could prevent preterm birth. Patients and methods This was a randomized controlled clinical trial involving two groups of women who underwent vaginal cerclage at Ain Shams University Maternity Hospital. One group received azithromycin 500mg one tablet orally once daily for 3 days every month from 14th week to 34th week gestation, in addition to routine antenatal care; while the other group received usual antenatal care without antibiotic prophylaxis after cerclage. Follow-up was done and we compared the outcomes in each group: gestational age at delivery, birth weight, mode of delivery, maternal complications, and perinatal complications. ClinicalTrials.gov Identifier NCT04278937. Results Gestational age at delivery was significantly higher in the azithromycin group (36.8weeks vs 34.1weeks; P = 0.017), with significant prolongation of gestation in the azithromycin group (23.7weeks vs 21.1weeks; P = 0.005). As regards birth weight, it was significantly higher in the azithromycin group (2932.6gm vs 2401.8gm; P = 0.006); however babies with low birth weight (birth weight <2500gm) were non-significantly less frequent in the azithromycin group (3cases vs 7cases; P = 0.165). There was no significant difference between the two groups as regards other outcomes (miscarriage, stillbirth, neonatal intensive care unit admission, antepartum hemorrhage, postpartum pyrexia, need for blood transfusion). Conclusion Adding azithromycin as antenatal prophylaxis in women undergoing vaginal cerclage prolongs pregnancy and reduces risk of PTB, with slight increase in birth weight. However, there was no clear effect on incidence of low birth weight, or perinatal morbidity/mortality.

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Factors that predict epinephrine induced constriction of the persistent arterial duct

Cardiology in the Young ◽

10.1017/s1047951100006077 ◽

1998 ◽

Vol 8 (2) ◽

pp. 195-198 ◽

Cited By ~ 3

Author(s):

Hideshi Tomita ◽

Shigeto Fuse ◽

Shunzo Chiba

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

The Body ◽

Low Birth Weight Infants ◽

Flow Area ◽

Arterial Duct ◽

Significant Difference ◽

History Of ◽

Persistent Arterial Duct

SummaryWe studied factors that predict in children catecholamine induced vasoconstriction of the persistent arterial duct. Epinephrine at 2.0–10.0 (4.9 ± 1.3, mean ± standard deviation) μg/kg was injected intravenously into 30 patients with persistent arterial duct whose age ranged from 1 to 91 (27 ± 26) months. In 11 patients aged 10–66 (34 ± 23) months (responders), a continuous murmur had almost completely disappeared on auscultation, and both the diameter and the shunt flow area of the arterial duct had become smaller as shown by Doppler echocardiography. On the other hand, there was no such change in 19 patients aged 1–91 (23 ± 27) months (non-responders). Although there was no significant difference in the age, the body weight, the minimal diameter of the arterial duct, or the doses of epinephrine between responders and non-responders, the gestational age at birth was slightly less (p=0.09) and the birth weight was significantly smaller in responders than in non-responders (p<0.05). The persistent arterial duct of those who had a history of low birth weight always responded to epinephrine. In infants younger than 6 months, the persistent arterial duct was never constricted by epinephrine regardless of the birth weight and gestational age. In low birth weight infants, the vascular smooth muscle of the persistent arterial duct can usually constrict beyond infancy. There may be some age dependent difference in responsiveness to epinephrine until 6 months of age.

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Reference values for the external genitalia of full-term and pre-term female neonates

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2019-318090 ◽

2020 ◽

Vol 106 (1) ◽

pp. 39-44

Author(s):

Sarah Castets ◽

Kim-An Nguyen ◽

Franck Plaisant ◽

Malika Baya Prudon ◽

Ingrid Plotton ◽

...

Keyword(s):

Birth Weight ◽

Reference Values ◽

Gestational Age ◽

Neonatal Period ◽

External Genitalia ◽

Full Term ◽

Significant Difference ◽

Study Centre ◽

The Mean ◽

A Prospective Study

Background and objectivesIdentifying virilisation of the genitalia in female newborns early during the neonatal period is important to diagnose pathologies. However, there is no clear threshold for clitoromegaly or for the anogenital ratio. The objective of this study was to define reference values for the external genitalia of full-term and pre-term female neonates.DesignThis was a prospective study of all females born in the study centre between May 2014 and July 2016. Clitoral length and anogenital ratio were measured in 619 newborns with a gestational age of 24+2 to 41+3 weeks during their first 3 days of life. Associations between the values at day 3 and gestational age, birth weight and other newborn characteristics were examined by linear regression.ResultsThe mean clitoral length at day 3 of life was 3.69±1.53 mm (n=551; 95th percentile, 6.5 mm; maximum, 8 mm), and the mean anogenital ratio was 0.42±0.09 (95th percentile, 0.58). There was no significant variation with gestational age or birth weight, and no significant difference between the results at day 0 and day 3.ConclusionThese results suggest that clitoromegaly can be defined as a clitoral length >6.5 mm. Values ≥8 mm should prompt further investigations. An anogenital ratio >0.6 should be considered a sign of virilisation. Since clitoral size does not vary with gestational age or birth weight, clitoromegaly should not be attributed to prematurity.

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The influence of birth weight and gestational age on kidney function in premature infants

Российский педиатрический журнал ◽

10.46563/1560-9561-2021-24-4-222-230 ◽

2021 ◽

Vol 24 (4) ◽

pp. 222-230

Author(s):

Bella D. Tsintsadze ◽

Klavdiya A. Kazakova ◽

Vladislav V. Chernikov ◽

Andrey P. Fisenko ◽

Aleksey N. Tsygin

Keyword(s):

Early Childhood ◽

Birth Weight ◽

Low Birth Weight ◽

Serum Creatinine ◽

Premature Infants ◽

Gestational Age ◽

Full Term ◽

Enzymatic Method ◽

Term Infants ◽

Blood Creatinine

Introduction. The impact of prematurity on the functional state of the kidneys in infants has not yet been sufficiently studied. Aim. To determine the influence of birth weight and gestational age on the creatinine level in the blood and glomerular filtration rate (GFR) in early childhood. Materials and methods. A retrospective analysis was conducted on medical records of 316 children aged from 1 month to 1.5 years, hospitalized at the Department of Early Childhood Pathology (National Medical Research Center for Children’s Health, Moscow) from 2012 to 2020 due to consequences of perinatal CNS damage. Children without congenital kidney diseases, with normal urine values in medical history, without structural abnormalities on ultrasound were included in this study. Serum creatinine was determined by the enzymatic method, GFR - by the Schwartz’s formula using a coefficient of 0.413, as well as, previously proposed coefficients of 0.33 for premature and 0.44 for full-term infants. Results. In premature infants, notably born with extremely low birth weight and very low birth weight, at the age of 1 year, serum creatinine is reduced compared to full-term infants, GFR in deep-premature infants exceeds the level of GFR in full-term infants by the year. The results allow concluding the method of calculating GFR by formulas based on serum creatinine to be invalid. Due to possible hyperfiltration in preterm infants, they need regular monitoring urine tests, blood pressure, due to the risk of developing chronic kidney disease. Conclusions. It is necessary to search for other methods for determining GFR in extremely premature infants. The established indices of the blood creatinine content can be used as reference values for different periods of gestation and body weight at birth in institutions using the enzymatic method for determining blood creatinine. The obtained GFR indices as a reference can be recommended for full-term and premature babies born after 32 weeks of gestation and with a birth weight of more than 1500 g.

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