Oral-motor Dysfunction at 10 Months Corrected Gestational Age in Infants Born Less Than 37 Weeks Preterm

Buswell, Charlotte; Leslie, Paula; Embleton, Nicholas D.; Drinnan, Michael

doi:10.1007/s00455-008-9161-4

“…These visits may have greater importance for premature infants who are at increased risk for medical and neurodevelopmental sequelae. [2][3][4][5][6][7][8][9][10][11][12][13][14][15] There are few studies assessing adherence with health supervision visits in the general pediatric population and fewer in high-risk populations. According to Medical Expenditure Survey data, infants were found to be 83% adherent with the age-specific number of visits recommended by the AAP.…”

mentioning

confidence: 99%

Preterm Infant Attendance at Health Supervision Visits

D’Agostino

¹

,

Passarella

²

,

Saynisch

³

et al. 2015

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OBJECTIVES: To assess the adherence of premature infants with the American Academy of Pediatrics health supervision visit schedule, factors affecting adherence, and the association of adherence with preventive care. METHODS:Retrospective cohort of all infants #35 weeks' gestation, born 2005 to 2009, receiving care at a 30-site primary care network for at least 24 months (n = 1854). Adherence was defined as having a health supervision visit within each expected time period during the first 18 months of life. Logistic regression identified sociodemographic and medical factors associated with nonadherence and risk-adjusted association between nonadherence and outcomes.RESULTS: Only 43% received all expected health supervision visits. Those with Medicaid insurance (adjusted odds ratio [AOR] 0.46, 95% confidence interval [CI] 0.35-0.60), a visit without insurance (AOR 0.46, 95% CI 0.32-0.67), chronic illness (AOR 0.7, 95% CI 0.51-0.97), and black race (AOR 0.7, 95% CI 0.50-0.98) were less adherent, whereas provider continuity of care (AOR 2.89, 95% CI 1.92-4.37) and lower birth weight (AOR 1.67, 95% CI 1.02-2.73) increased adherence. Infants ,100% adherent were less likely to be up to date with immunizations and receive recommended preventive care. In nearly half of missed visit windows, no health supervision visit was scheduled.CONCLUSIONS: Fewer than half of premature infants were fully adherent with the preventive health schedule with associated gaps in health monitoring and immunization delays. These data suggest the importance of health supervision visits and the need to explore scheduling facilitators for those at risk for nonadherence. WHAT'S KNOWN ON THIS SUBJECT:Premature infants are at risk for medical and neurodevelopmental sequelae. Close monitoring is an important role for primary care providers. Premature infants have high use of health care services; however, little is known about the role of health supervision visits. WHAT THIS STUDY ADDS:This study explores the utilization and value of health supervision visits for premature infants. Fewer than half were found to be fully adherent to the health supervision visit schedule, resulting in preventive care gaps and immunization delays.

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“…These visits may have greater importance for premature infants who are at increased risk for medical and neurodevelopmental sequelae. [2][3][4][5][6][7][8][9][10][11][12][13][14][15] There are few studies assessing adherence with health supervision visits in the general pediatric population and fewer in high-risk populations. According to Medical Expenditure Survey data, infants were found to be 83% adherent with the age-specific number of visits recommended by the AAP.…”

Section: What This Study Addsmentioning

confidence: 99%

Preterm Infant Attendance at Health Supervision Visits

2015

PEDIATRICS

0

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OBJECTIVES: To assess the adherence of premature infants with the American Academy of Pediatrics health supervision visit schedule, factors affecting adherence, and the association of adherence with preventive care. METHODS:Retrospective cohort of all infants #35 weeks' gestation, born 2005 to 2009, receiving care at a 30-site primary care network for at least 24 months (n = 1854). Adherence was defined as having a health supervision visit within each expected time period during the first 18 months of life. Logistic regression identified sociodemographic and medical factors associated with nonadherence and risk-adjusted association between nonadherence and outcomes.RESULTS: Only 43% received all expected health supervision visits. Those with Medicaid insurance (adjusted odds ratio [AOR] 0.46, 95% confidence interval [CI] 0.35-0.60), a visit without insurance (AOR 0.46, 95% CI 0.32-0.67), chronic illness (AOR 0.7, 95% CI 0.51-0.97), and black race (AOR 0.7, 95% CI 0.50-0.98) were less adherent, whereas provider continuity of care (AOR 2.89, 95% CI 1.92-4.37) and lower birth weight (AOR 1.67, 95% CI 1.02-2.73) increased adherence. Infants ,100% adherent were less likely to be up to date with immunizations and receive recommended preventive care. In nearly half of missed visit windows, no health supervision visit was scheduled.CONCLUSIONS: Fewer than half of premature infants were fully adherent with the preventive health schedule with associated gaps in health monitoring and immunization delays. These data suggest the importance of health supervision visits and the need to explore scheduling facilitators for those at risk for nonadherence.

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“…Studies have suggested an association between a younger gestational age and greater risk of the development of oral motor disorders. Thus, the intervention of a speech therapists is important to the prevention and rehabilitation of correlate abnormalities and should be maintained throughout the follow up of cases during the introduction of other food consistencies 16,17 .…”

Section: Figure 2 -Most Frequent Diagnostic Hypotheses Given By Physimentioning

confidence: 99%

Demanda para intervenção fonoaudiológica em uma unidade neonatal de um hospital-escola

Monti

¹

,

Botega

²

,

Lima

³

et al. 2013

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Conflito de interesses: inexistente difficulties 1,2 due to the effect of prematurity, low birth weight and clinical conditions on the feeding process.Speech and hearing therapy in the neonatal period is focused on aspects of feeding, the development of hearing and language and mother-infant interactions. The aim of assisting in the feeding process is to promote healthy, efficient feeding in terms of nutrition, weight gain and the mother-infant bond and minimize the risk of aspiration and stress 1,3,4 . This therapy should include an evaluation, the early detection of uncoordinated sucking-swallowingbreathing and deficient or absent reflexes of the oral motor sensory system, orientation of the neonatal team regarding feeding issues, stimulation of the oral motor sensory system, outpatient follow up and the encouragement of breastfeeding 5 . The aim of motor sensory stimulation is to facilitate the dietary transition and speed up discharge from hospital in cases of intubation or prolonged use of a feeding ABSTRACT Purpose: the aim of the present study was to characterize the demand for speech therapy among newborns with oral feeding difficulties at a neonatal unit of a public teaching school. Methods: a descriptive, retrospective, cross-sectional study was carried out using data obtained from all charts of newborns interned between March 2008 and February 2010 who received at least one speech/ hearing evaluation/intervention. Results: two hundred five newborns were treated in the study period, 104 of whom met the inclusion criteria. The sample was predominantly male, composed of premature newborns with adequate gestational age (mean: 36 weeks) and low birth weight. The most frequent diagnoses were respiratory disorder, jaundice and cardiovascular disorder. The following were the predominant reasons for requesting an evaluation by a speech therapist: abnormal oral motor behavior, evaluation of readiness for oral feeding and difficulties using a cup. Most evaluations were requested by residents when the newborns had a mean of 28 days of life. A broader set of criteria was used by the team requesting a speech therapy evaluation in comparison to criteria described in the literature. Conclusion: the majority of newborns receive oral feeding without a prior evaluation by a speech therapist, which can lead to situations of risk with regard to safe, efficient feeding.

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Oral-motor Dysfunction at 10 Months Corrected Gestational Age in Infants Born Less Than 37 Weeks Preterm

Cited by 28 publications

References 23 publications

Preterm Infant Attendance at Health Supervision Visits

Preterm Infant Attendance at Health Supervision Visits

Preterm Infant Attendance at Health Supervision Visits

Demanda para intervenção fonoaudiológica em uma unidade neonatal de um hospital-escola

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