Sequelae of Premature Birth

Lubchenco, Lula O.

doi:10.1001/archpedi.1963.02080050103017

Cited by 164 publications

(30 citation statements)

References 10 publications

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“…After delivery, the preterm infant was placed in an incubator with liberal amounts of oxygen and if still alive 2-3 days later, feedings were begun (frequent aspiration had discouraged earlier feeding) [Gordon, 1952]. Hyperoxia contributed to ROP in a third and blindness in 20% of survivors, while delayed feeding contributed to major disability in half [Drillien, 1961;Lubchenco et al, 1963;1972;Francis-Williams and Davies, 1974]. Antibiotics available to treat infections had unfortunate side effects in preterm infants, including hearing impairment with streptomycin, hyperbilirubinemia due to albumin binding with sulfonamides and "gray baby syndrome" (i.e., shock) with chloramphenicol.…”

Section: Historical Perspectivementioning

confidence: 99%

“…Rates of neurological and intellectual abnormalities increased as BW decreased in a longitudinal study comparing 500 low birthweight infants (LBW, with BW below 2500 grams) born in 1952 in Baltimore MD to 492 fullterm controls matched for SES and race [Knoblach et al, 1956;Wiener et al, 1968]. Over half of very low birthweight children (VLBW, with BW below 1500 grams) had major disability and required special education, and three quarters had behavior problems [Knoblach et al, 1956;Drillien, 1961;Lubchenco et al, 1963]. Although samples of preterm children demonstrated a normal range of intelligence, many more (46-69%) had low intelligence quotients (IQ below 90) than fullterm controls (8-9%).…”

Section: Historical Perspectivementioning

confidence: 99%

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Preterm outcomes research: A critical component of neonatal intensive care

Allen

2002

Ment. Retard. Dev. Disabil. Res. Rev.

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While early preterm outcome studies described the lives of preterm survivors to justify the efforts required to save them, subsequent studies demonstrated their increased incidence of cerebral palsy, mental retardation, sensory impairments, minor neuromotor dysfunction, language delays, visual-perceptual disorders, learning disability and behavior problems compared to fullterm controls. Because infants born at the lower limit of viability require the most resources and have the highest incidence of neurodevelopmental disability, there is concern that resources have gone primarily to neonatal intensive care and are not available for meeting the followup, health, educational and emotional needs of these fragile infants and their families. Despite many methodological concerns, preterm outcome studies have provided insight into risk factors for and causes of CNS injury in preterm infants. Nevertheless, it remains difficult to predict neurodevelopmental outcome for individual preterm infants. Perinatal and neonatal risk factors are inadequate proxies for neurodevelopmental disability. Recent randomized controlled trials with one to five year neurodevelopmental followup have provided valuable information about perinatal and neonatal treatments. Recognizing adverse longterm neurodevelopmental effects of pharmacological doses of postnatal steroids is a sobering reminder of the need for longterm neurodevelopmental followup in all neonatal randomized controlled trials. Ongoing longterm preterm neurodevelopmental studies, analysis of changes in outcomes over time and among centers, and evaluation of the longterm safety, efficacy and effectiveness of many perinatal and neonatal management strategies and proposed neuroprotective agents are all necessary for further medical and technological advances in neonatal intensive care.

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Section: Historical Perspectivementioning

confidence: 99%

Section: Historical Perspectivementioning

confidence: 99%

Preterm outcomes research: A critical component of neonatal intensive care

Allen

2002

Ment. Retard. Dev. Disabil. Res. Rev.

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“…In fact, many studies are available to show that babies "born too soon or born too small" (46) are at a high risk for developing behavioral disorders, particularly hyperactivity and learning disabilities (41)(42)(43)(44)(45)(105)(106)(107)(108)(109), with boys displaying this syndrome more often than girls (46). Since only a small proportion of the high-risk children are diagnosed as suffering from behavioral abnormalities, and some of the potential disorders may be prevented by special care, it may be advisable to screen those at risk for the presence of retarded brain development and its extent by using the magnetic resonance imaging technique.…”

Section: Morphological and Behavioral Markers Of Retarded Brain Develmentioning

confidence: 99%

“…In a retrospective study, Pasamanick and Knobloch (36) found that a higher proportion of children with school problems than matched control children had perinatal medical complications, and that their major symptom was hyperactivity. Several large-scale recent studies have established that prematurely born babies and small-for-date babies are at a high risk for developing hyperactivity and/or learning disabilities (41)(42)(43)(44)(45)(46).…”

mentioning

confidence: 99%

Morphological and behavioral markers of environmentally induced retardation of brain development: an animal model.

Altman

1987

Environ Health Perspect

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In most neurotoxicological studies morphological assessment focuses on pathological effects, like degenerative changes in neuronal perikarya, axonopathy, demyelination, and glial and endothelial cell reactions. Similarly, the assessment of physiological and behavioral effects center on evident neurological symptoms, like EEG and EMG abnormalities, resting and intention tremor, abnormal gait, and abnormal reflexes. This paper reviews briefly another central nervous system target of harmful environmental agents, which results in behavioral abnormalities without any qualitatively evident neuropathology. This is called microneuronal hypoplasia, a retardation of brain development characterized by a quantitative reduction in the normal population of late-generated, short-axoned neurons in specific brain regions.Correlated descriptive and experimental neurogenetic studies in the rat have established that all the cerebellar granule cells and a very high proportion of hippocampal granule cells are produced postnatally, and that focal, low-dose X-irradiation either of the cerebellum or of the hippocampus after birth selectively interferes with the acquisition of the full complement of granule cells (microneuronal hypoplasia). Subsequent behavioral investigations showed that cerebellar microneuronal hypoplasia results in profound hyperactivity without motor abnormalities, while hippocampal microneuronal hypoplasia results in hyperactivity, as well as attentional and learning deficits.There is much indirect clinical evidence that various harmful environmental agents affecting the pregnant mother and/or the infant lead to such childhood disorders as hyperactivity and attentional and learning disorders. As the developing human brain is more mature at birth than the rat brain, the risk for microneuronal hypoplasia and consequent behavioral disorders may be highest at late stages of fetal development, in prematurely born and small-for-weight infants, and during the early stages of infant development. Recent technological advances in brain imaging techniques make it possible to test this hypothesis and to assess the possible relationship between the degree of retarded brain development and ensuing behavioral disorders.

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“…Mortality rate and long-term out come were discouraging [1][2][3][4][5]. During recent years considerable improvement in the sur vival rate and short-and long-term outcome of these tiny infants has been reported [6][7][8][9][10], as a result of improved antenatal fetal and maternal monitoring, an increased tendency to perform operative deliveries for fetal indi cations, and of considerable improvement in neonatal intensive care [8,11].…”

Section: Introductionmentioning

confidence: 99%

Neonatal Outcome of Infants Delivered at 26–28 Weeks of Gestation

Altaras

Cohen

Reisner

et al. 1985

Gynecol Obstet Invest

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The delivery results of 42 infants born to 40 mothers at the gestational age of 26–28 weeks during a period of 5 years were analyzed. The study was evaluated in two periods of time: in the first period out of 15 infants born only 5 (33.3%) survived, while in the second period 21 (77.7%) out of 27 infants survived (p < 0.01). 38 infants were transferred to a neonatal intensive care unit for premature infants. Only 41 % of the infants transferred in the first period survived, as compared to 80.7% of those transferred during the second period (p < 0.01). There was no significant difference in the mean birth weight at each gestational age between the survivors and those who subsequently died in both periods of the study. In the study groups, cesarean section rate rose from 13.3% in the first period to 44% in the second. Mode of delivery, regardless of the presenting part, did not seem to influence neonatal survival. Obstetrical management, including the performance of operative delivery for fetal indications and active neonatal resuscitation, seems to be reasonable for infants at the gestational age of 26 weeks or more.

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Sequelae of Premature Birth

Cited by 164 publications

References 10 publications

Preterm outcomes research: A critical component of neonatal intensive care

Preterm outcomes research: A critical component of neonatal intensive care

Morphological and behavioral markers of environmentally induced retardation of brain development: an animal model.

Neonatal Outcome of Infants Delivered at 26–28 Weeks of Gestation

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