Neurodevelopmental Outcomes Among Extremely Preterm Infants 6.5 Years After Active Perinatal Care in Sweden

Serenius, Fredrik; Ewald, Uwe; Farooqi, Aijaz; Fellman, Vineta; Hafström, Maria; Hellgren, Karin; Maršál, Karel; Ohlin, Andreas; Olhager, Elisabeth; Stjernqvist, Karin; Strömberg, Bo; Ådén, Ulrika; Källén, Karin

doi:10.1001/jamapediatrics.2016.1210

Cited by 237 publications

(285 citation statements)

References 34 publications

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“…The higher LVM in adults could be attributed to higher blood pressures in adults who were born preterm than in those born at term,4 whereas blood pressure differences in our cohort were small or nonexistent. Infants,19 children,7 and adolescents8 born preterm have—as in our cohort—been found to exhibit similar or even lower LVM than peers born at term, also in the presence of elevated blood pressure 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20…”

Section: Discussionsupporting

confidence: 64%

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The Preterm Heart in Childhood: Left Ventricular Structure, Geometry, and Function Assessed by Echocardiography in 6‐Year‐Old Survivors of Periviable Births

Mohlkert

Hallberg

Broberg

et al. 2018

JAHA

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BackgroundPreterm birth has been associated with increased risk of cardiovascular morbidity in adult life. We evaluated whether preterm birth is associated with deviating cardiac structure and function before school start.Methods and ResultsIn total, 176 children aged 6 years and born extremely preterm (EXPT; gestational age of 22–26 weeks) and 134 children born at term (control [CTRL]) were studied. We used echocardiography to assess left heart dimensions, geometry, and functions. Recording and off‐line analyses of echocardiographic images were performed by operators blinded to group belonging. Body size, blood pressure, and heart rate were also measured. Rates of family history of cardiovascular disease and sex distribution were similar in the EXPT and CTRL groups. Heart rate and systolic blood pressure did not differ, whereas diastolic blood pressure was slightly higher in EXPT than CTRL participants. After adjusting for body surface area, left ventricular length, width, and aortic valve annulus diameter were 3% to 5% smaller in EXPT than CTRL participants. Left ventricular longitudinal shortening and systolic tissue velocity were 7% to 11% lower, and transversal shortening fraction was 6% higher in EXPT than CTRL participants. The EXPT group also exhibited lower atrial emptying velocities than the CTRL group. Sex, fetal growth restriction, or a patent ductus arteriosus in the neonatal period did not contribute to cardiac dimensions or performance.ConclusionsSix‐year‐old children born extremely preterm exhibit a unique cardiac phenotype characterized by smaller left ventricles with altered systolic and diastolic functions than same‐aged children born at term.

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Section: Discussionsupporting

confidence: 64%

“…Inclusion and exclusion criteria, perinatal characteristics, and data on survival, neonatal morbidity, neurodevelopmental outcomes at 30 months and 6.5 years of age, and vascular outcomes in childhood have been reported previously 9, 10, 11, 12, 13…”

Section: Methodsmentioning

confidence: 99%

The Preterm Heart in Childhood: Left Ventricular Structure, Geometry, and Function Assessed by Echocardiography in 6‐Year‐Old Survivors of Periviable Births

Mohlkert

Hallberg

Broberg

et al. 2018

JAHA

Self Cite

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“…Although early neurodevelopmental assessment is important for the timely identification of children at risk for long-term neurologic impairment or developmental delay, its capacity to predict later functioning is limited. [35][36][37] Many children will catch up to their peers by school age, whereas other children will have persistent impairment. Conversely, some children without signs of neurodevelopmental impairment in early childhood will have impairments that manifest at school age.…”

Section: Discussionmentioning

confidence: 99%

Survival and Neurodevelopmental Outcomes Among Periviable Infants

Younge¹,

Goldstein²,

Bann³

et al. 2017

Obstetric Anesthesia Digest

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“…1 Preterm delivery is an international health problem and is responsible for approximately two-thirds of early neonatal morbidity and mortality. 2,3 Yet, current evidence shows that it is possible to reduce the complications caused by prematurity. 4,5 Consequently, tocolytic therapy has a well-defined role in the management of preterm labor, accomplishing the following objectives: permitting transfer of the pregnant woman to a tertiary care center; prolonging pregnancy for at least 48 h to optimize the ben-eficial effect of steroids on fetal lung maturity; and prolonging pregnancy in an attempt to improve perinatal outcome.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Maternal Nifedipine as a Tocolytic Agent on the Doppler Indices of Uterine and Fetal Umbilical and Middle Cerebral Arteries

Abdellateef¹,

Shorbagy²,

Hagras³

et al. 2017

Gynecol Obstet Res Open J

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CitationAbdellateef SS, El Shorbagy SH, Hagras AM, Ghareeb AE. Assessment of maternal nifedipine as a tocolytic agent on the Doppler indices of uterine and fetal umbilical and middle cerebral arteries. This study was designed to assess the effects of maternal nifedipine administration on blood flow resistance in uterine, umbilical and fetal middle cerebral arteries by evaluating resistance index (RI) and pulsatility index (PI). Patients and Methods: This was a prospective, observational, analytic cohort study performed in 50 pregnant women undergoing nifedipine tocolysis, all women with a singleton pregnancy between 24 and 34 weeks of gestation, each subject acting as her own control. Doppler assessment of uterine, umbilical and fetal middle cerebral (MCA) arteries was performed before and 24 h and 72 h after an initial 20 mg oral dose, which was repeated at 20 min intervals if contractions failed to diminish up to a total maximum dose of 60 mg. The maintenance dose consisted of 20 mg orally every 6 h. We analyzed whether there was a time effect and compared values at the different time-points. Results: The research showed that the UtA-RI has increased significantly after 24 h and after 72 h of nifedipine administration (0 h=0.53; 24 h=0.56; 72 h=0.55; p=0.002, p=0.015 respectively). The MCA-RI had decreased significantly after 24 h (p=0.003) of tocolysis returning to baseline after 72 h (0 h=0.75; 24 h=0.73; 72 h=0.74; p=0.150). The MCA-PI had decreased significantly after 24 h (P=0.024) of tocolysis returning to baseline between 24 h and 72 h (0 h=1.85; 24 h=1.75; 72 h=1.79; p=0.204), with no differences in UtA-PI or in the umbilical arteries Doppler (RI & PI) or in the MCA to umbilical artery ratio. Conclusions: Nifedipine tocolysis is associated with a reduction in RI and PI in the MCA, and an increase in RI in uterine arteries after 24 h but returning to baseline within 72 h, with no long-term effect on fetomaternal circulation in pregnant women at risk of preterm delivery.

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Neurodevelopmental Outcomes Among Extremely Preterm Infants 6.5 Years After Active Perinatal Care in Sweden

Cited by 237 publications

References 34 publications

The Preterm Heart in Childhood: Left Ventricular Structure, Geometry, and Function Assessed by Echocardiography in 6‐Year‐Old Survivors of Periviable Births

The Preterm Heart in Childhood: Left Ventricular Structure, Geometry, and Function Assessed by Echocardiography in 6‐Year‐Old Survivors of Periviable Births

Survival and Neurodevelopmental Outcomes Among Periviable Infants

Assessment of Maternal Nifedipine as a Tocolytic Agent on the Doppler Indices of Uterine and Fetal Umbilical and Middle Cerebral Arteries

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