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Despite an increase in secondary intraventricular bleeding, DRIFT reduced severe cognitive disability in survivors and overall death or severe disability.

BackgroundProgressive ventricular dilatation after intraventricular haemorrhage (IVH) in preterm infants has a very high risk of severe disability and death. Drainage, irrigation and fibrinolytic therapy (DRIFT), in a randomised controlled trial (RCT), reduced severe cognitive impairment at 2 years.ObjectiveTo assess if the cognitive advantage of DRIFT seen at 2 years persisted until school age.ParticipantsThe RCT conducted in four centres recruited 77 preterm infants with IVH and progressive ventricular enlargement over specified measurements. Follow-up was at 10 years of age.InterventionIntraventricular injection of a fibrinolytic followed by continuous lavage, until the drainage was clear, and standard care consisting of control of expansion by lumbar punctures and if expansion persisted via a ventricular access device.Primary outcomeCognitive quotient (CQ), derived from the British Ability Scales and Bayley III Scales, and survival without severe cognitive disability.ResultsOf the 77 children randomised, 12 died, 2 could not be traced, 10 did not respond and 1 declined at 10-year follow-up. 28 in the DRIFT group and 24 in the standard treatment group were assessed by examiners blinded to the intervention. The mean CQ score was 69.3 (SD=30.1) in the DRIFT group and 53.7 (SD=35.7) in the standard treatment group (unadjusted p=0.1; adjusted p=0.01, after adjustment for the prespecified variables sex, birth weight and IVH grade). Survival without severe cognitive disability was 66% in the DRIFT group and 35% in the standard treatment group (unadjusted p=0.019; adjusted p=0.003).ConclusionDRIFT is the first intervention for posthaemorrhagic ventricular dilatation to objectively demonstrate sustained cognitive improvement.Trial registration numberISRCTN80286058.

Objective: Several researchers and clinicians have focused on the negative consequences of the COVID-19 pandemic for children and parents. However, we may suppose that some families may also experience positive aspects of the COVID-19 lockdown such as increased emotional closeness and more time for free play and creativity in parent-child relationships. The aim of the current study was to investigate predictors of the positive experiences in parent-child relationship in Polish mothers and fathers during the COVID-19 outbreak. Methods: 228 mothers and 231 fathers completed the Brief version of the Empathic Sensitivity Questionnaire, The Difficulties in Emotion Regulation Scale Short Form, Social Support Scale, Parenting Self-Agency Measure, as well as The Scale of Positive Experiences in Parent-Child Relationship during the COVID-19 lockdown. Results: Our results show that parenting self-efficacy and social support are the best predictors of the positive experiences in parent-child relationships in both mothers and fathers during the lockdown. Additionally, perspective taking is a positive predictor of the positive experiences in mothers, whereas increased affective components of empathy (empathic concern and personal distress) are predictors of the positive experiences in the parent-child relationship in fathers. Conclusions: Our study emphasizes a need to focus not only on negative, but also on positive consequences of COVID-19 lockdown for children and parents, and shows which factors could be important targets for preventive and therapeutic interventions for mothers and fathers during the epidemic.

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