Neonatal Cranial Ultrasound Lesions and Developmental Delays at 2 Years of Age Among Extremely Low Gestational Age Children

O’Shea, T. Michael; Kuban, Karl; Allred, Elizabeth N.; Paneth, Nigel; Pagano, Marcello; Dammann, Olaf; Bostic, Lisa; Brooklier, Kara; Butler, Samantha; Goldstein, Donald J.; Hounshell, Gail; Keller, Cecelia; McQuiston, Susan; Miller, Alice; Pasternak, Steve; Plesha-Troyke, Susan; Price, Joan T.; Romano, Elaine; Solomon, Katherine M.; Jacobson, Amanda; Westra, Sjirk J.; Leviton, Alan

doi:10.1542/peds.2008-0594

Cited by 132 publications

(127 citation statements)

References 61 publications

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“…Rates of cognitive impairment alone at 24 months in preterm infants, especially those born less than 32 weeks gestational age, range from 23 to 47% [2][3][4]. Behavior problems are also associated with lower cognitive scores [5].…”

Section: Developmental Outcome In Preterm Infantsmentioning

confidence: 99%

Neurobehavior Related to Epigenetic Differences in Preterm Infants

et al. 2015

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Preterm birth is associated with medical problems affecting the neuroendocrine system, altering cortisol levels resulting in negative effects on newborn neurobehavior. Newborn neurobehavior is regulated by DNA methylation of NR3C1 and HSD11B2. Aim: Determine if methylation of HSD11B2 and NR3C1 is associated with neurobehavioral profiles in preterm infants. Patients & methods: Neurobehavior was measured before discharge from the hospital in 67 preterm infants. Cheek swabs were collected for DNA extraction. Results: Infants with the high-risk neurobehavioral profile showed more methylation than infants with the low-risk neurobehavioral profile at CpG3 for NR3C1 and less methylation of CpG3 for HSD11B2. Infants with these profiles were more likely to have increased methylation of NR3C1 and decreased methylation of HSD11B2 at these CpG sites. Conclusion: Preterm birth is associated with epigenetic differences in genes that regulate cortisol levels related to high-risk neurobehavioral profiles.

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Section: Developmental Outcome In Preterm Infantsmentioning

confidence: 99%

Neurobehavior Related to Epigenetic Differences in Preterm Infants

et al. 2015

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“…46 In the ELGAN cohort, it has been associated with ventriculomegaly of the offspring, 47 which, in turn, is associated with low MDI. 4 One antecedent that we identified, maternal obesity, is of particular interest because it is potentially modifiable and its prevalence is increasing. 48 Although maternal obesity is predictive of higher maternal blood levels of Creactive protein 49 and interleukin-6, 50 we found no indirect evidence to support a link between maternal inflammation, as indicated by placental findings and initiators of preterm delivery, and subsequent impaired infant cognitive function.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Cognitive impairment is the most frequent developmental problem identified in extremely premature survivors. [3][4][5] Impaired early cognitive function, assessed with the Bayley Scales of Infant Development (BSID), is moderately predictive of cognitive function at school age. 6 Antenatal factors associated with cognitive limitations in ELGANs include unmarried mother, 7 minority race, 5 fewer years of education, 5 lack of antenatal steroid exposure, 5,8 maternal smoking during pregnancy, 8 and preeclampsia.…”

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confidence: 99%

Antenatal Antecedents of Cognitive Impairment at 24 Months In Extremely Low Gestational Age Newborns

2012

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WHAT'S KNOWN ON THIS SUBJECT: Among extremely premature infants, survival has improved, but the rate of cognitive impairment has not. Impaired cognition is the most frequent developmental problem identified in survivors. Several antenatal factors have been associated with cognitive impairment, mostly related to social disadvantage. WHAT THIS STUDY ADDS:In addition to social disadvantage, antenatal characteristics associated with cognitive impairment include maternal obesity and thrombosis of fetal stem vessels. Prenatal infection and inflammation were not associated with impaired early cognitive function among extremely preterm infants. abstract BACKGROUND AND OBJECTIVES: Extremely low gestational age neonates are more likely than term infants to develop cognitive impairment. Few studies have addressed antenatal risk factors of this condition. We identified antenatal antecedents of cognitive impairment determined by the Mental Development Index (MDI) portion of the Bayley Scales of Infant Development, Second Edition (BSID-II), at 24 months corrected age. METHODS:We studied a multicenter cohort of 921 infants born before 28 weeks of gestation during 2002 to 2004 and assessed their placentas for histologic characteristics and microorganisms. The mother was interviewed and her medical record was reviewed. At 24 months adjusted age, children were assessed with BSID-II. Multinomial logistic models were used to estimate odds ratios. RESULTS:A total of 103 infants (11%) had an MDI ,55, and 99 infants (11%) had an MDI between 55 and 69. No associations were identified between organisms recovered from the placenta and developmental delay. Factors most strongly associated with MDI ,55 were thrombosis of fetal vessels (OR 3.1; 95% confidence interval [CI] 1.2, 7.7), maternal BMI .30 (OR 2.0; 95% CI 1.1, 3.5), maternal education #12 years (OR 3.4; 95% CI 1.9, 6.2), nonwhite race (OR 2.2; 95% CI 1.3, 3.8), birth weight z score , 22 (OR 2.8; 95% CI 1.1, 6.9), and male gender (OR 2.7; 95% CI 1.6, 4.5).CONCLUSIONS: Antenatal factors, including thrombosis of fetal vessels in the placenta, severe fetal growth restriction, and maternal obesity, convey information about the risk of cognitive impairment among extremely premature newborns. Pediatrics 2012;129:494-502

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“…All infants had normal findings according to previously reported criteria (18). Brain magnetic resonance imaging was also performed at TEA in all infants using a Signa HDxt 1.5-Tesla imager (GE Healthcare, Buckinghamshire, UK) or a Sigma Horizon LX 1.5-Tesla imager (Yokokawa GE Medical, Tokyo, Japan) with conventional T1-weighted, T2-weighted, and fluid-attenuated inversion recovery imaging.…”

Section: Articlesmentioning

confidence: 99%

Differences in amplitude among electrode locations on amplitude-integrated electroencephalograms in preterm infants

et al. 2012

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IntroductIon: To assess differences in amplitude among electrode locations on amplitude-integrated electroencephalograms (aeeGs) in preterm infants and change therein between preterm age and term-equivalent age (Tea), we investigated aeeGs in preterm infants at both 30-32 wk post-conceptional age (Pca) and Tea. Methods:The median values of upper-and lower-margin amplitudes were quantitatively calculated every 5 min (MedUMa5 and Med-LMa5, respectively), and peak, median, and bottom values were extracted at each location for the trans-frontal, trans-central, trans-occipital, fronto-central, and centro-occipital electrodes. results: In 38 clinically stable preterm infants studied, most measurement items showed significant differences among the electrode locations at both preterm age and Tea. at 30-32 wk Pca, the bottom of Med-LMa5 was significantly higher for the trans-frontal electrodes than for the trans-central electrodes. In contrast, all measurements for Med-LMa5 were significantly lower for the trans-frontal electrodes than for the trans-central electrodes. dIscussIon: amplitudes on aeeGs were significantly different among the electrode locations in preterm infants, and locational differences in amplitude changed between preterm age and Tea. It is necessary to understand the differences in amplitudes among the electrode locations on aeeGs in infants to appropriately evaluate them.

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Neonatal Cranial Ultrasound Lesions and Developmental Delays at 2 Years of Age Among Extremely Low Gestational Age Children

Abstract: BACKGROUND-Studies of the relationship between ultrasound images from preterm newborns and developmental delay most often are based on small samples defined by birth weight and exclude infants not testable with standardized assessments.

Cited by 132 publications

References 61 publications

Neurobehavior Related to Epigenetic Differences in Preterm Infants

Neurobehavior Related to Epigenetic Differences in Preterm Infants

Antenatal Antecedents of Cognitive Impairment at 24 Months In Extremely Low Gestational Age Newborns

Differences in amplitude among electrode locations on amplitude-integrated electroencephalograms in preterm infants

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