Adverse neurodevelopmental outcome in preterm infants: risk factor profiles for different gestational ages

Kiechl‐Kohlendorfer, Ursula; Ralser, Elisabeth; Peglow, Ulrike Pupp; Reiter, Gernot; Trawöger, Rudolf

doi:10.1111/j.1651-2227.2009.01219.x

Cited by 81 publications

(56 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Entretanto, vários estudos mostram associação entre o crescimento fetal e pós-natal e o desenvolvimento neurocognitivo. Estudo recente mostrou que ser pequeno para a idade gestacional é fator independente de risco para o neurodesenvolvimento de prematuros menores que 30 semanas, aumentando em 4,5 vezes a chance de atraso no desenvolvimento 23 . Em prematuros de muito baixo peso, avaliados na idade escolar, documentou-se efeito do inadequado crescimento intrauterino no desenvolvimento cognitivo, mas não no desenvolvimento motor 24 .…”

Section: Idade Cronológicaunclassified

Acquisition of motor abilities up to independent walking in very low birth weight preterm infants

et al. 2010

View full text Add to dashboard Cite

Objective: To determine chronological and corrected ages at acquisition of motor abilities up to independent walking in very low birth weight preterms and to determine up to what point it is necessary to use corrected age. Methods:This was a longitudinal study of preterms with birth weight < 1,500 g and gestational age ≤ 34 weeks, free from neurosensory sequelae, selected at the high-risk infants follow-up clinic at the Hospital das Clínicas, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP) in Botucatu, Brazil, between 1998 to 2003, and assessed every 2 months until acquisition of independent walking.Results: Nine percent of the 155 preterms recruited were excluded from the study, leaving a total of 143 patients. The mean gestational age was 30±2 weeks, birth weight was 1,130±222 g, 59% were female and 44% were small for gestational age. Preterms achieved head control in their second month, could sit independent at 7 months and walked at 12.8 months' corrected age, corresponding to the 4th, 9th and 15th months of chronological age. There were significant differences between chronological age and corrected age for all motor abilities. Preterms who were small for their gestational age acquired motor abilities later, but still within expected limits. Conclusions:Very low birth weight preterms, free from neurosensory disorders, acquired their motor abilities within the ranges expected for their corrected ages. Corrected age should be used until independent walking is achieved. J Pediatr (Rio J). 2010;86(2):143-148:Very low birth weight newborn, motor activity, development, gestational age. ResumoObjetivo: Determinar as idades cronológica e corrigida de aquisição das habilidades motoras até a marcha independente em prematuros de muito baixo peso e avaliar até quando é necessário o uso da idade corrigida.Métodos: Estudo longitudinal de prematuros < 1.500 g e com idade gestacional ≤ 34 semanas, sem alterações neurossensoriais, selecionados no ambulatório de seguimento de recém-nascidos de alto risco do Hospital das Clinicas da Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu (SP), no período de 1998 a 2003, e avaliados a cada 2 meses até a aquisição da marcha independente.Resultados: Dos 155 prematuros incluídos, 9% foram excluídos, sendo estudados 143 pacientes. A idade gestacional média foi 30±2 semanas, o peso ao nascimento, 1.130±222 g, 59% foram do sexo feminino e 44%, pequenos para idade gestacional. Os prematuros controlaram a cabeça no 2º mês, sentaram sem apoio aos 7 meses e andaram com 12,8 meses de idade corrigida, correspondendo respectivamente ao 4 o , ao 9 o e ao 15 o mês de idade cronológica. Para todas as habilidades motoras houve diferença significativa entre idade cronológica e corrigida. Prematuros pequenos para idade gestacional adquiriram suas habilidades mais tardiamente, porém dentro do limite esperado. Conclusões:Prematuros de muito baixo peso, sem alterações neurossensoriais, adquirem as habilidades motoras dentro do prazo prev...

show abstract

Section: Idade Cronológicaunclassified

Acquisition of motor abilities up to independent walking in very low birth weight preterm infants

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Pregnancy-induced hypertension was defined as the development of new arterial hypertension (blood pressure over 140/90 mmHg) during pregnancy, after 20 weeks gestation and without proteinuria. Given the association of PROM with poor motor outcome [8][9][10], we examined the role of chorioamnionitis as measured by placental histopathology, a more sensitive measure of intrauterine infection [25]. To measure early illness severity, we used SNAP-II during the first 24 hours of life; SNAP-II quantifies six physiological variables (blood pressure, temperature, PO 2 /fraction of inspired oxygen, serum pH, seizures, and urine output), with higher scores reflecting more disturbances in neonatal physiology [14].…”

Section: Clinical Data Collectionmentioning

confidence: 99%

“…Our aim was to explore in a prospective cohort of premature newborns serially studied with diffusion tensor imaging, the associations of established risk factors for motor impairment with development of the major motor pathway measured with diffusion tensor tractography. These risk factors include antenatal exposures, such as pregnancy-induced hypertension [6], gestational diabetes [7], and intrauterine inflammation [8][9][10], as well as male sex [11][12][13]. Putative perinatal and post-natal risk factors include early illness severity as measured by the Score of Neonatal Acute Physiology-Version II (SNAP-II) [14,15], infection [9,16,17], necrotizing enterocolitis [16,17], patent ductus arteriosus [18], chronic lung disease [18][19][20][21], and neonatal procedural pain [22].…”

Section: Introductionmentioning

confidence: 99%

Score for Neonatal Acute Physiology–II and Neonatal Pain Predict Corticospinal Tract Development in Premature Newborns

Zwicker¹,

Grunau²,

Adams³

et al. 2013

Pediatric Neurology

115

View full text Add to dashboard Cite

Premature infants are at risk for adverse motor outcomes, including cerebral palsy and developmental coordination disorder. The purpose of this study was to examine the relationship of ante-, peri-, and postnatal risk factors for abnormal development of the corticospinal tract, the major voluntary motor pathway, during the neonatal period. In a prospective cohort study, 126 premature neonates (24-32 weeks gestational age) underwent serial brain imaging near birth and at term-equivalent age. Using diffusion tensor tractography, mean diffusivity and fractional anisotropy of the corticospinal tract were measured to reflect microstructural development. Generalized estimating equation models examined associations of risk factors on corticospinal tract development.The perinatal risk factor of greater early illness severity [as measured by the Score for Neonatal Acute Physiology-II (SNAP-II)] was associated with a slower rise in fractional anisotropy of the corticospinal tract (p=0.02), even after correcting for gestational age at birth and postnatal risk factors (p=0.009). Consistent with previous findings, neonatal pain adjusted for morphine and postnatal infection were also associated with a slower rise in fractional anisotropy of the corticospinal tract (p=0.03 and 0.02 respectively). Lessening illness severity in the first hours of life might offer potential to improve motor pathway development in premature newborns.

show abstract

“…Essa diferença pode ser observada inclusive ao realizar a comparação do desenvolvimento de crianças nascidas a termo e pré-termo em idade pré-escolar 10 . A vulnerabilidade biológica dos prematuros pode estar associada a riscos psicossociais do contexto no qual a criança está inserida [11][12][13] . Nesse sentido, a criança fica exposta a condição de múltiplo risco, que tem efeito negativo no seu desenvolvimento.…”

unclassified

Developmental outcomes and quality of life in children born preterm at preschool- and school-age

Vieira¹,

Linhares²

2011

J Pediatr (Rio J)

View full text Add to dashboard Cite

Objective: To review literature published in the last 5 years on the effects of premature birth on the development and quality of life of preschool-and school-age children.Source: Systematic review of empirical studies published in the last 5 years and indexed on PubMed, MEDLINE, LILACS, SciELO and PsycINFO. Keywords were chosen that relate prematurity to developmental and quality of life outcomes. Summary of the findings:In the studies chosen, four global indicators of development were identified (neurological, neurodevelopment, executive functions and quality of life), in addition to seven specific indicators of development (cognition, motor function, behavior, language, academic performance, attention and memory). The most prevalent indicators were cognition and motor function. Premature children had worse performance in all developmental indicators than children born full term. Additionally, the younger the gestational age, the worse the performance in developmental indicator assessments. The studies identified both risk factors (lower birth weight, intraventricular hemorrhage and low maternal educational level) and protective factors (larger head circumference, breastfeeding and higher family income) for development of children born preterm. Conclusion ResumoObjetivo: Revisar a literatura publicada nos últimos 5 anos sobre o efeito do nascimento prematuro no desenvolvimento e qualidade de vida de crianças nas fases pré-escolar e escolar. Fonte dos dados:Revisão sistemática de estudos empíricos dos últimos 5 anos indexados nas bases de dados PubMed, MEDLINE, LILACS, SciELO e PsycINFO. Utilizaram-se palavras-chave que associaram a prematuridade aos desfechos de desenvolvimento e qualidade de vida. Síntese dos dados:Nos estudos, foram identificados quatro indicadores globais do desenvolvimento (neurológico, neurodesenvolvimento, funções executivas e qualidade de vida) e sete indicadores específicos do desenvolvimento (cognição, motor, comportamento, linguagem, desempenho escolar, atenção e memória). Os indicadores mais prevalentes foram cognição e motor. Os prematuros apresentaram pior desempenho em todos os indicadores de desenvolvimento quando comparados às crianças nascidas a termo. Além disso, quanto menor a idade gestacional, pior o desempenho nas avaliações dos indicadores de desenvolvimento. Verificou-se a presença de fatores de risco (menor peso ao nascer, hemorragia intraventricular e baixo nível educacional da mãe) e fatores de proteção (maior perímetro cefálico, aleitamento materno e maior renda familiar) do desenvolvimento de crianças nascidas pré-termo. Conclusão:Crianças nascidas com prematuridade extrema (≤ 30 semanas de idade gestacional) são vulneráveis para apresentar problemas no desenvolvimento e na qualidade de vida.J Pediatr (Rio J). 2011;87(4):281-291: Desenvolvimento infantil, qualidade de vida, prematuro.

show abstract

Adverse neurodevelopmental outcome in preterm infants: risk factor profiles for different gestational ages

Cited by 81 publications

References 32 publications

Acquisition of motor abilities up to independent walking in very low birth weight preterm infants

Acquisition of motor abilities up to independent walking in very low birth weight preterm infants

Score for Neonatal Acute Physiology–II and Neonatal Pain Predict Corticospinal Tract Development in Premature Newborns

Developmental outcomes and quality of life in children born preterm at preschool- and school-age

Contact Info

Product

Resources

About