Risk for Behavioral Problems Independent of Cognitive Functioning in Children Born at Low Gestational Ages

Domellöf, Erik; Johansson, Anna-Maria; Farooqi, Aijaz; Domellöf, Magnus; Rönnqvist, Louise

doi:10.3389/fped.2020.00311

Cited by 9 publications

(24 citation statements)

References 46 publications

(96 reference statements)

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“…Gestational age at birth, specifically the gestational age in and of itself is independent of substance exposure, is an important factor in anticipating infant's medical risks and nursing care needs [15]. And the association between gestational age and cognitive impairment was observed in previous population analysis [16,17]. In previous studies, the gestational age at birth was shorter among the MAexposed infants compared to nonexposed infants in general.…”

Section: Gestational Agementioning

confidence: 99%

Effects of Prenatal Methamphetamine Exposure on Birth Outcomes, Brain Structure, and Neurodevelopmental Outcomes

et al. 2021

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This study reviews the findings from previous research on the effects of prenatal methamphetamine (MA) exposure on birth outcomes, brain structure, and neurodevelopmental outcomes of the offspring. These findings indicate that prenatal MA exposure may lead to shorter gestational age, lower birth weight, lower head circumference, and shorter body length of neonatal, structural brain changes, and impairment in cognitive development, motor development, inhibitory control, and attention of children from 1 to 15 years. Based on these findings of the previous cohort studies on the effect of prenatal MA exposure on the birth outcomes and childhood outcomes of the offspring, we conclude by discussing the shortcomings and inconsistencies of previous studies in each section. A multicenter, large-scale population-based prospective cohort study is needed to establish and seek the differences and similarities of the pathological changes in different systems among offspring prenatally exposed to MA in different periods. And the pathophysiology mechanism underlying these changes should be studied by the method of omics technology in future. These efforts are of great significance to address the adverse health outcomes caused by prenatal MA exposure.

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Section: Gestational Agementioning

confidence: 99%

Effects of Prenatal Methamphetamine Exposure on Birth Outcomes, Brain Structure, and Neurodevelopmental Outcomes

et al. 2021

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“…Survival has been published as early as 21 weeks of gestation, improving rapidly from around 7% of live births at 22 weeks to 90% at 27 weeks (Myrhaug et al 2019). Most ex-preemies live good lives (Saigal 2016), but infants born before 26 weeks of gestation still present high mortality and significant long-term complications, including impaired neurodevelopmental outcome and psychological and behavioral problems (Domellof et al 2020;Myrhaug et al 2019;O'Reilly et al 2020).…”

Section: The Gray Zonementioning

confidence: 99%

Postponed Withholding: Balanced Decision-Making at the Margins of Viability

Syltern

Ursin

Solberg

et al. 2021

The American Journal of Bioethics

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Advances in neonatology have led to improved survival for periviable infants. Immaturity still carries a high risk of short-and long-term harms, and uncertainty turns provision of life support into an ethical dilemma. Shared decision-making with parents has gained ground. However, the need to start immediate life support and the ensuing difficulty of withdrawing treatment stands in tension with the possibility of a fair decision-making process. Both the parental "instinct of saving" and "withdrawal resistance" involved can preclude shared decision-making. To help health care personnel and empower parents, we propose a novel approach labeled "postponed withholding." In the absence of a prenatal advance directive, life support is started at birth, followed by planned redirection to palliative care after one week, unless parents, after a thorough counseling process, actively ask for continued life support. Despite the emotional challenges, this approach can facilitate ethically balanced decision-making processes in the gray zone.

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“…The origin of behavioral problems in preterm infants is not fully understood yet. So far, most studies hypothesized that behavioral problems in preterm infants are associated with NDI and environmental factors, such as parental level of education and socioeconomic status (5)(6)(7)(8). Indeed, environmental factors have been proven to be crucial factors influencing the behavioral outcome of preterm infants (6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

“…So far, most studies hypothesized that behavioral problems in preterm infants are associated with NDI and environmental factors, such as parental level of education and socioeconomic status (5)(6)(7)(8). Indeed, environmental factors have been proven to be crucial factors influencing the behavioral outcome of preterm infants (6)(7)(8)(9)(10). However, behavioral problems do not seem to necessarily be associated with NDI in preterm infants (5,6).…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, environmental factors have been proven to be crucial factors influencing the behavioral outcome of preterm infants (6)(7)(8)(9)(10). However, behavioral problems do not seem to necessarily be associated with NDI in preterm infants (5,6). Neonatal morbidities as potential risk factors for later behavioral problems in preterm infants have rarely been studied.…”

Section: Introductionmentioning

confidence: 99%

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Neonatal sepsis is associated with behavioral abnormalities in very low birthweight infants at preschool age

et al. 2022

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ObjectiveThis study aimed to investigate neonatal sepsis as potential risk factor for adverse behavioral outcome in very low birth weight infants (VLBWI) at preschool age. Regardless of improvements in the obstetric and neonatal intensive care, preterm infants are still at high risk for behavioral problems later in life. The spectrum, origin and potential risk factors of these behavioral problems have not been well-defined.MethodsIn this retrospective observational study, the influence of culture-proven neonatal sepsis on the behavioral outcome of VLBWI born at a gestational age <32 weeks was analyzed at 5 years of age in a multivariable regression model. Behavior was assessed with the Child Behavior Checklist (CBCL). Neonatal morbidities, socioeconomic status and neurodevelopmental outcome served as covariates in the analysis.Results312 VLBWI entered the final analysis, of whom 11% had experienced neonatal sepsis. Neonatal sepsis appeared to be a relevant risk factor for both internalizing, i.e., emotional reactivity and anxiety/depression, as well as externalizing behavioral problems, i.e., oppositional and aggressive behavior in this cohort of VLBWI. Low socioeconomic status and male gender were additional statistically significant risk factors for both internalizing and externalizing behavioral problems. No difference in neurocognitive development was observed between the groups.ConclusionThe study supports the fact that VLBWI are vulnerable to multiple behavioral disorders independent of their cognitive development. In contrast to former assumptions, the results of the study emphasize that not only post-natal environment but also neonatal morbidities, especially neonatal sepsis, have an impact on behavioral outcome of VLBWI at preschool age.

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Risk for Behavioral Problems Independent of Cognitive Functioning in Children Born at Low Gestational Ages

Cited by 9 publications

References 46 publications

Effects of Prenatal Methamphetamine Exposure on Birth Outcomes, Brain Structure, and Neurodevelopmental Outcomes

Effects of Prenatal Methamphetamine Exposure on Birth Outcomes, Brain Structure, and Neurodevelopmental Outcomes

Postponed Withholding: Balanced Decision-Making at the Margins of Viability

Neonatal sepsis is associated with behavioral abnormalities in very low birthweight infants at preschool age

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