Neurological, psychological and articulatory impairment in five-year-old children with a birthweight of 2000 g or less

Michelsson, Katarina; Noronen, M

doi:10.1007/bf00496798

Cited by 41 publications

(19 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although similar evidence of functional impairment related to poor DHA accumulation has not been demonstrated in very low birth weight infants, those with normal intelligence at school age nevertheless have significantly poorer school performance compared to their peers born at term. In at least two recent reports, poor school performance was associated with some degree of impaired visualmotor function (23,24).…”

Section: Discussionmentioning

confidence: 99%

Effect of Fish Oil Supplementation on the n-3 Fatty Acid Content of Red Blood Cell Membranes in Preterm Infants

et al. 1987

View full text Add to dashboard Cite

ABSTRACT. Very low birth weight infants demonstrate significant reductions in red blood cell membrane docosahexaenoic acid (DHA, 22:6n-3) following delivery unless fed human milk. The purpose of the present study was to determine if a dietary source of DHA (MaxEPA, R. P. Scherer Corporation, Troy, MI) could prevent the decline in red blood cell phospholipid DHA in very low birth weight infants whose enteral feeding consisted of a preterm formula without DHA. Longitudinal data were obtained on membrane phospholipid DHA in both unsupplemented and MaxEPA-supplemented infants by a combination of thinlayer and gas chromatography. These infants (n = 39) ranged in age from 10 to 53 days at enrollment (0 time). At enrollment, phospholipid DHA and arachidonic acid (20:4n-6) were inversely correlated with age in days. During the study, mean red blood cell phospholipid DHA declined without supplementary DHA as determined by biweekly measurement, but infants supplemented with MaxEPA maintained the same weight percent of phospholipid (phosphatidylethanolanine, phosphatidylcholine, and phosphatidylserine) DHA as at enrollment. and retinal membranes (3). Dietary manipulations which limit accumulation of DHA to 25-50% of controls in these membranes were associated with a 33% reduction in discrimination learning in rats (4), significant reductions in electroretinogram a-wave amplitudes (5), and a 25% loss of visual acuity in the rhesus monkey (5, 6). Furthermore, changes in electroretinograms observed after early deprivation persist following subsequent biochemical normalization of retinal membrane DHA in both species (5,7). Accumulation of DHA in the central nervous system begins at about the 26th wk of gestation in the human fetus (8) with the weight percent of phospholipid DHA approaching adult levels by term (9). Studies in developing rats suggest that differences in red blood cell phospholipid DHA are indicative of qualitative differences in accumulation in the central nervous system. Studies done in very low birth weight preterm infants showed that red blood cell PE DHA was high at birth, but the weight percent declined in the period before infants were nourished completely by orogastric feedings (1). Subsequently, an additional decline in PE DHA occurred in infants fed formula, whereas DHA increased in infants fed mother's milk (I).Infant formula contains linolenic acid (1 8:3n-3) a precursor of DHA. Linoleic (18:2n-6) and linolenic acid are not interconvertible and compete for elongation and desaturation by the same enzyme system. Thus conversion of 20:3n-6 to 20:4n-6 and 20:4n-3 to 20:5n-3 is catalyzed by A5-desaturase and the elongation products of 20:4n-6 and 20:5n-3 (22:4n-6 and 22:5n-3, respectively) are converted to 22:5n-6 and 22:6n-3 by A4-desaturase.Humans appear to have low A4-desaturase activity as indicated by the following observations: 1) diets enriched in 18:3n-3 increase phospholipid 20:5n-3 the A5-desaturase product, but not 22:6n-3, its A4-desaturase product (10); 2) red blood cell membrane phospholipid...

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of Fish Oil Supplementation on the n-3 Fatty Acid Content of Red Blood Cell Membranes in Preterm Infants

et al. 1987

View full text Add to dashboard Cite

show abstract

“…Language development has been found to be delayed in children born prematurely 12,21 . Our results did not show a significant difference between both groups.…”

Section: Discussionmentioning

confidence: 99%

Evolutional neurologic evaluation of seven year-old children born prematurely

Ohlweiler

1996

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

-A sample of 51 children aged 7 with a history of prematurity was compared to 44 age-matched children who were born at term at the HCPA. The premature children had had gestational ages up to 37 weeks and 6 days and were born weighing less than 2500g. The control group consisted of children born with gestational age between 38 and 42 weeks and weights above 2S00g. The evaluation criteria were clinical examination, neurological examination and the evolutional neurological evaluation (ENE). The results pointed out that impulsiveness, aggressiveness, disorganization and enuresis were prevalent symptoms of developmental disturbances in the sample of prematures. Alterations at neurological examination did not discriminate between the two groups, although cerebral palsy occurred only in the proup of prematures. The ENE functions which differentiated the two groups studied were dynamic balance, appendicular and trunk-limb coordination and motor persistence.KEY WORDS: prematurely born children, development, evolutional neurologic evaluation. Avaliação neurológica evolutiva aos sete anos de idade de crianças nascidas prematurasRESUMO -Para estudar o desenvolvimento neuropsicomotor em amostra de prematuros aos 7 anos de idade, foram avaliadas 51 crianças prematuras e comparadas com 44 a termo. O grupo de prematuros tinha idade gestacional de até 37 semanas e 6 dias e peso de nascimento até 2500g. O grupo controle foi constituído de crianças com idade gestacional entre 38 e 42 semanas e acima de 2500g. Os instrumentos de avaliação utilizados foram os exames clinico, neurológico e neurológico evolutivo (ENE). Os resultados mostraram que impulsividade, agressividade, desorganização e enurese foram sintomas prevalentes nos prematuros. As alterações no exame neurológico não discriminaram os grupos, embora paralisia cerebral só tenha ocorrido nos prematuros. As funções do ENE que distinguiram os grupos foram equilíbrio dinâmico, coordenação tronco-membros e persistência motora, constituindo-se esta no comprometimento dominante nos prematuros e as alterações na coordenação tronco-membros em achado peculiar neste grupo. PALAVRAS-CHAVE: prematuridade, desenvolvimento neuropsicomotor, exame neurológico evolutivo.It has been well established that the development of the central nervous system (CNS) begins at conception and continues to adulthood. Psychomotor development has also been observed during intrauterine life 22 . CNS development is achieved through a series of transformations. An early phase of neuronal proliferation that occurs between the second and fourth month of gestation involves neurons and glial cells derived from the ventricular and sub-ventricular zones. During a second phase of neuronal migration, between the third and fifth month of gestation, millions of neurons move from their original site to their final locations. A third phase involves the organization that begins around the sixth month of gestation and persists for several years. Lastly, the final phase of neuronal maturation is related to the myeli...

show abstract

“…In our series six of eight children with psychomotor problems had a birth weight under 2500 g and were born before gestational week 37. Bloch-Petersen et al [23,24] also found that low birth weight and prematurity were associated with an increased risk of poor performance at age 4-5 years when examining 90 children of diabetic mothers in Denmark. Moreover, large series of children weighing < 2000 g or less at birth, born to non-diabetic mothers, found significantly more, albeit mostly minor, developmental problems at school age than in infants with higher birth weight [19,20,25].…”

Section: Discussionmentioning

confidence: 99%

Pregnancies in women with diabetic nephropathy: long-term outcome for mother and child

et al. 1995

View full text Add to dashboard Cite

SummaryIn order to improve the basis upon which to advise women with diabetic nephropathy about pregnancy, we studied the effect of diabetic nephropathy on the course of pregnancy, perinatal outcome, infant development and long-term outcome of the mothers. All pregnancies of women with diabetic nephropathy (defined as proteinuria > 400 mg/day (n = 26), creatinine clearance < 80 ml/min and hypertension in the first trimester (n = 10)) followed at our centre from 1982 to 1992 were identified (34 White class F and 2 White class T) and the women and their children re-examined in the spring 1993. From the first to the third trimester the percentage of women with proteinuria over 3 g/day increased from 14 to 53 % and those treated with antihypertensive medication from 53 to 97 %. There were no intrauterine or perinatal deaths, but one child died suddenly 4 weeks postpartum. Of 36 newborns (gestational week at birth 36(3), birth weight 2384(834) g)), 11 were born before week 34 and 8 had respiratory distress syndrome. Renal function in the first trimester, diastolic blood pressure in the third trimester and an HbAlc above normal were predictive of gestational age at delivery and low birth weight (stepwise regression analysis). At follow-up of the children (n = 35, age 4.5 (0.4-10) years) the majority (n = 27) were normally developed but seven had psychomotor retardation (four of them major). One child had a severe motor retardation due to a congenital anomaly. At follow up, 21 of the 29 mothers had preserved renal function (creatinine 1.3 (0.8-4.3) mg/dl and 8 had developed end stage renal disease and required dialysis (2 of whom were White class T) within 3 (1-9) years postpartum. Of those, 4 women (3 White F and i White T) had died. Pregnancy did not seem to specifically accelerate the rate of decline of renal function. In women with diabetic nephropathy perinatal mortality can be prevented but perinatal and long-term infant morbidity remains elevated. Women with severely impaired renal function before pregnancy are at risk for serious morbidity when their children are still young. Improvement might be made if all women were to receive specialized care and counselling before, throughout and after pregnancy. [Diabetologia (1995) Today the perinatal outcome of pregnancies of diabetic women without advanced diabetic complications is similar to that in non-diabetic women, if there is normoglycaemic control throughout pregnancy. Therefore, in women with well-controlled diabetes who do not have nephropathy or other advanced vascular complications their decision about whether or not to have children will largely be influenced by factors not associated with diabetes itself. In contrast, for women with diabetic nephropathy (who in most cases also have proliferative retinopa-

show abstract

Neurological, psychological and articulatory impairment in five-year-old children with a birthweight of 2000 g or less

Cited by 41 publications

References 17 publications

Effect of Fish Oil Supplementation on the n-3 Fatty Acid Content of Red Blood Cell Membranes in Preterm Infants

Effect of Fish Oil Supplementation on the n-3 Fatty Acid Content of Red Blood Cell Membranes in Preterm Infants

Evolutional neurologic evaluation of seven year-old children born prematurely

Pregnancies in women with diabetic nephropathy: long-term outcome for mother and child

Contact Info

Product

Resources

About