Neurodevelopmental Outcomes at 4 to 8 Years of Children Born at 22 to 25 Weeks’ Gestational Age

Moore, Gregory P.; Lemyre, Brigitte; Barrowman, Nick; Daboval, Thierry

doi:10.1001/jamapediatrics.2013.2395

Cited by 114 publications

(75 citation statements)

References 64 publications

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“…Z-scores for healthy subjects have been calculated for the IOS outcome variables AX and R [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] in Finnish and Mexican children. 26,27 Depending on which reference used in the calculations, we found that the mean z-score for AX (before reversibility test) among healthy 6½-year-old children participating in our study (those with asthma reductions of 16% associated with mild BPD and 19% for moderate to severe BPD.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Thunqvist

Tufvesson

Bjermer

et al. 2017

Pediatric Pulmonology

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Section: Discussionmentioning

confidence: 99%

“…Spirometry outcomes in children born extremely preterm did not differ significantly between those born SGA and those born AGA. However, children born SGA had higher R [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] assessed with IOS than those born AGA.…”

Section: Lung Function In Children Born Extremely Preterm and Sgamentioning

confidence: 99%

Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Thunqvist

Tufvesson

Bjermer

et al. 2017

Pediatric Pulmonology

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“…30 Infants born at 22 weeks' gestation have reported rates of moderate to severe neurodevelopmental impairment of 85% to 90%; for infants born at 23 weeks' gestation, these rates are not significantly lower. [29][30][31][32] The risk of permanent, severe neurodevelopmental and other special health care needs affect both the infant and the family and, for some parents, may outweigh the benefit of survival alone. [33][34][35][36] …”

Section: Outcome According To Gestational Agementioning

confidence: 99%

Antenatal Counseling Regarding Resuscitation and Intensive Care Before 25 Weeks of Gestation

Cummings¹,

Watterberg²,

Eichenwald³

et al. 2015

Pediatrics

231

133

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The anticipated birth of an extremely low gestational age (<25 weeks) infant presents many difficult questions, and variations in practice continue to exist. Decisions regarding care of periviable infants should ideally be well informed, ethically sound, consistent within medical teams, and consonant with the parents’ wishes. Each health care institution should consider having policies and procedures for antenatal counseling in these situations. Family counseling may be aided by the use of visual materials, which should take into consideration the intellectual, cultural, and other characteristics of the family members. Although general recommendations can guide practice, each situation is unique; thus, decision-making should be individualized. In most cases, the approach should be shared decision-making with the family, guided by considering both the likelihood of death or morbidity and the parents’ desires for their unborn child. If a decision is made not to resuscitate, providing comfort care, encouraging family bonding, and palliative care support are appropriate.

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“…Preterm births are associated with neurodevelopmental morbidities, including impairment of cognitive, language and motor function as well as increased risk for autism spectrum disorders [1,2,3,4,5,6,7,8]. Despite improvements in obstetrical and neonatal care in the past few decades, the number of survivors with neurological sequelae that affect quality of life has remained unchanged.…”

Section: Introductionmentioning

confidence: 99%

MRI Differences Associated with Intrauterine Growth Restriction in Preterm Infants

Bruno

Bengani

Gomes³

et al. 2017

Neonatology

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Background: Preterm infants are at risk for neurodevelopmental impairment. Intrauterine growth restriction (IUGR) further increases this risk. Brain imaging studies are often utilized at or near term-equivalent age to determine later prognosis. Objective: To evaluate the association between intrauterine growth and regional brain volume on MRI scans performed in preterm infants at or near term-equivalent age. Methods: This is a retrospective case-control study of 24 infants born at gestational age ≤30 weeks and cared for in a large, inner-city, academic neonatal intensive-care unit from 2012 to 2013. Each IUGR infant was matched with 1-2 appropriate for gestational age (AGA) infants who served as controls. Predischarge MRI scans routinely obtained at ≥36 weeks' adjusted age were analyzed for regional brain volumetric differences. We examined the association between IUGR and thalamic, basal ganglion, and cerebellar brain volumes in these preterm infants. Results: Compared to AGA infants, IUGR infants had a smaller thalamus (7.88 vs. 5.87 mL, p = 0.001) and basal ganglion (8.87 vs. 6.92 mL, p = 0.002) volumes. There was no difference in cerebellar volumes between the two study groups. Linear regression analyses revealed similar trends in the associations between IUGR and brain volumes after adjusting for sex, gestational age at birth, and postconceptual age and weight at MRI. Conclusions: Thalamus and basal ganglion volumes are reduced in growth-restricted preterm infants. These differences may preferentially impact neurodevelopmental outcomes. Further research is needed to explore these relationships.

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Neurodevelopmental Outcomes at 4 to 8 Years of Children Born at 22 to 25 Weeks’ Gestational Age

Abstract: Knowledge of these data, including the limitations, should facilitate discussion during the shared decision-making process about care plans for these infants, particularly in centers without their own data. More prospective, high-quality, complete cohorts are needed.

Cited by 114 publications

References 64 publications

Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Antenatal Counseling Regarding Resuscitation and Intensive Care Before 25 Weeks of Gestation

MRI Differences Associated with Intrauterine Growth Restriction in Preterm Infants

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