scholarly journals Az extrém kis születési súlyú koraszülöttek fejlődésének követése az óvodáskor végéig a perinatalis szövődmények tükrében

2018 ◽  
Vol 159 (41) ◽  
pp. 1672-1679
Author(s):  
Anett Nagy ◽  
Anna Mária Beke ◽  
Renáta Cserjési ◽  
Rózsa Gráf ◽  
Magda Kalmár
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Developmental Outcomes ◽  
Extremely Low Birth Weight ◽  
Psychomotor Development ◽  
Preterm Children ◽  
Extremely Preterm ◽  
The Mean

Abstract: Introduction: Owing to the rapid progress of the medical science and technology, the chances of survival of the extremely low birth weight (<1000 g) preterm babies have dramatically improved. Nevertheless, the research findings on their long-term developmental outcome are inconsistent. Aim: Our study has attempted to contribute to the understanding of the developmental mechanisms in the extremely low birth weight preterm infants and to the prediction of the developmental outcomes taking into account of the risk factors of development. Method: 34 preterm children who were free of any major central nervous system injury were followed up from one to 5–6 years of age. The psychomotor development of the infants was assessed at 1 and 2 years of age and, at 5–6 years of age, intelligence tests were administered to the children. Perinatal and environmental factors were included in the data analysis. Results: The extremely low birth weight preterm children as a group displayed no developmental delay at any of the measurement points. The mean developmental quotients were 98.6 and 106.6 at ages 1 and 2 years, respectively. At 5–6 years of age, the mean verbal IQ was 101.4, while the mean performance IQ was 92.9. Behind the group means there was a wide range of individual variations. The most powerful contributors to the developmental outcomes were birth weight, bronchopulmonary dysplasia, intra-uterine growth retardation, gender, and maternal education. The girls had a significant advantage over the boys in language development. Verbal intelligence was hampered by intracranial hemorrhage, while intrauterine growth restriction had a similar effect on the performance IQ. Conclusions: Our results suggest that even the extremely preterm infants may have rather good chances of satisfactory mental development. However, the individual developmental prospects are influenced by a great number of domain-specific risk- and protective factors. Although at a group-level, infant psychomotor development is a significant predictor of later intelligence quotient, the rate of development may change at any age. The phenomenon of “moving risk” underscores the importance of the long-term follow-up of preterm infants. Orv Hetil. 2018; 159(41): 1672–1679.

More than Just a Fad: Building and Maintaining a Small Baby Program

2021 ◽  
Vol 40 (4) ◽  
pp. 224-232
Author(s):  
Ching Ching Tay ◽  
Serena de la O ◽  
Summer Finn ◽  
James Fritzell
Keyword(s):  
At Risk ◽  
Birth Weight ◽  
Survival Rate ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Continuous Improvement ◽  
Extremely Low Birth Weight ◽  
Change Model ◽  
Model Framework

Survival rate for preterm infants has improved significantly in the last decade because of advancements in care provided by NICUs. Yet, a large proportion of extremely low birth weight (ELBW) infants continue to be at risk of being discharged home from NICUs with long-term co-morbidities. Several centers have introduced and described the concept of a focused program on the care of micro-preemies and demonstrated improved processes as well as outcomes utilizing a continuous improvement approach with adoption of standardized guidelines, checklists, and shared team values. The journey and effort that it takes to develop and sustain such a program have been described less. This article discusses the process of building a Small Baby Program using a change model framework, how the organization and staff bought into the concept, as well as the accomplishments and challenges experienced during the last 3 years as the program continues to evolve and grow.

scholarly journals Concentrated Preterm Formula as a Liquid Human Milk Fortifier at Initiation Stage in Extremely Low Birth Weight Preterm Infants: Short Term and 2-year Follow-up Outcomes

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2229 ◽  
Author(s):  
Yung-Chieh Lin ◽  
Yen-Ju Chen ◽  
Chao-Ching Huang ◽  
Chi-Chang Shieh
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Volume Ratio ◽  
Extremely Low Birth Weight ◽  
Improvement Project ◽  
Preterm Formula ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Human milk (HM) must be accurately fortified for extremely low birth weight (ELBW) preterm infants with human milk fortifiers (HMFs). Powdered HMF has some limitations in terms of sterilization and accuracy. A concentrated preterm formula (CPF) may serve as a safe liquid HMF to facilitate growth. Hence, we launched a quality improvement project for fortification accuracy of minute volume HM. A CPF, Similac Special Care 30 (SSC30), was newly introduced as an HMF when daily feeding reached 100 cm3/kg. CPF + HM (1:2 volume ratio), CPF + HM (1:1 volume ratio), and powdered HMF + HM (1 packet in 25 cm3) represented three fortification stages. Fortification shifted to powdered HMF while tolerable feeding reached 25 cm3/meal. The outcome was compared before (Period-I, January 2015 to June 2016, n = 37) and after the new implement (Period-II, July 2016 to December 2017, n = 36). Compared with the Period-I group, the Period-II group had significantly higher daily enteral milk intake in the first 4 weeks of life, and higher percentages of fortification in the HM-fed infants in the first 8 weeks after birth. The Period-II group also significantly increased in body weight growth in terms of z-score at term equivalent age (p = 0.04) and had better language and motor performance at 24 months old (p = 0.048 and p = 0.032, respectively). Using the liquid CPF as a strategical alternative fortification of HM might be beneficial for extremely preterm infants in terms of growth as well as neurodevelopment.

Neonatal seizures in extremely preterm infants with very and extremely low birth weight: prevalence and transformation into structural epilepsy

2021 ◽  
Vol 10_2021 ◽  
pp. 134-142
Author(s):  
Suvorov I.A. Suvorov ◽  
Amirkhanova D.Yu. Amirkhanova ◽  
Degtyareva A.V. Degtyareva ◽  
Degtyarev D.N. Degtyarev D ◽  
Albegova M.B. Albegova ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Extremely Low Birth Weight ◽  
Neonatal Seizures ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Structural Epilepsy

Is intravenous fish oil associated with the neurodevelopment of extremely low birth weight preterm infants on parenteral nutrition?

2021 ◽  
Author(s):  
Chiara Biagetti ◽  
Alessio Correani ◽  
Rita D’Ascenzo ◽  
Enrica Ferretti ◽  
Cecilia Proietti ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Preterm Infants ◽  
Extremely Low Birth Weight

scholarly journals Microstructural Measures of the Inferior Longitudinal Fasciculus Predict Later Cognitive and Language Development in Infants Born With Extremely Low Birth Weight

2021 ◽  
pp. 088307382110198
Author(s):  
Matthew C. Bugada ◽  
Julia E. Kline ◽  
Nehal A. Parikh
Keyword(s):  
Diffusion Tensor Imaging ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Language Development ◽  
Fractional Anisotropy ◽  
Diffusion Tensor ◽  
Structural Mri ◽  
Extremely Low Birth Weight ◽  
Extremely Preterm ◽  
Inferior Longitudinal Fasciculus

Objective: Extremely preterm children are at high risk for adverse neurodevelopmental outcomes. Identifying predictors of discrete developmental outcomes early in life would allow for targeted neuroprotective therapies when neuroplasticity is at its peak. Our goal was to examine whether diffusion magnetic resonance imaging (MRI) metrics of the inferior longitudinal and uncinate fasciculi early in life could predict later cognitive and language outcomes. Study Design: In this pilot study, 43 extremely low-birth-weight preterm infants were scanned using diffusion MRI at term-equivalent age. White matter tracts were assessed via diffusion tensor imaging metrics of fractional anisotropy and mean diffusivity. The Language and Cognitive subscale scores of the Bayley Scales of Infant & Toddler Development-III at 18-22 months corrected age were our outcomes of interest. Multiple linear regression models were created to assess diffusion metrics of the inferior longitudinal and uncinate fasciculi as predictors of Bayley scores. We controlled for brain injury score on structural MRI, maternal education, birth weight, and age at MRI scan. Results: Of the 43 infants, 36 infants had high-quality diffusion tensor imaging and returned for developmental testing. The fractional anisotropy of the inferior longitudinal fasciculus was associated with Bayley-III scores in univariate analyses and was an independent predictor of Bayley-III cognitive and language development over and above known predictors in multivariable analyses. Conclusions: Incorporating new biomarkers such as the fractional anisotropy of the inferior longitudinal fasciculus with structural MRI findings could enhance accuracy of neurodevelopment predictive models. Additional research is needed to validate our findings in a larger cohort.

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