| 1. |
- Berglund, Staffan, 1975-, et al.
(författare)
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Effects of iron supplementation on auditory brainstem response in marginally LBW infants
- 2011
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Ingår i: Pediatric Research. - Baltimore : International Pediatrics Research Foundation, Inc. - 0031-3998 .- 1530-0447. ; 70:6, s. 601-606
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Tidskriftsartikel (refereegranskat)abstract
- LBW infants are at risk of iron deficiency (ID), which is associated with impaired nervous system development and may lead to prolonged auditory brainstem response (ABR) latencies. We hypothesized that iron supplementation shortens ABR latencies in marginally LBW (MLBW, 2000-2500 g) infants. In a randomized, controlled trial, 285 healthy MLBW infants received 0, 1, or 2 mg iron/kg/d of iron supplements from 6 wk to 6 mo of age. ABR absolute wave V latencies and central conduction time (CCT) were measured at the endpoint. There were no significant differences between groups in ABR wave V latencies (n = 218). Furthermore, there were no significantly prolonged ABR latencies in infants with ID (n = 32). CCT was significantly higher in the 2 mg group than in the placebo group (n = 126). However, there were no significant correlations between CCT and iron intake or any iron status variable, suggesting that differences in CCT were not caused by iron. We conclude that iron supplements did not improve ABR latencies, and iron-deficient MLBW infants did not have impaired ABR latencies at 6 mo, suggesting that ABR is not a sensitive measure of impaired neurological development or that mild/moderate ID causes no such impairment in MLBW infants.
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| 2. |
- Berglund, Staffan K, et al.
(författare)
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Effects of iron supplements and perinatal factors on fetal hemoglobin disappearance in LBW infants
- 2014
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Ingår i: Pediatric Research. - : Nature Publishing Group. - 0031-3998 .- 1530-0447. ; 76:5, s. 477-482
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:The homeostatic mechanisms of iron metabolism and erythropoiesis in infants are unclear. Infants synthesize both fetal hemoglobin (HbF) and adult hemoglobin (HbA), and it is not known how the hemoglobin switch is regulated. We hypothesized that iron supplements to infants affect the disappearance of HbF. METHODS: We randomized 285 low-birth-weight infants (2,000-2,500g) into three intervention groups receiving 0, 1, or 2 mg/kg/d of iron supplements from 6 wk to 6 mo of age. In the present secondary analysis, we analyzed iron status, total hemoglobin (Hb), and HbF fraction at 6 wk, 12 wk, and at 6 mo and calculated absolute levels of HbF. RESULTS: We observed dose-dependent increased levels of Hb in iron-supplemented groups at 6 mo of age. However, for absolute HbF concentration, there was no similar effect of intervention. Mean (SD) HbF was 81.2 (16.8), 37.0 (13.8), and 8.1 (5.6) g/l at 6 wk, 12 wk, and 6 mo, respectively, similar in all groups. In linear regression analyses, postconceptional age turned out as the major predictor of HbF, independent of gestational age at birth. CONCLUSION: Our hypothesis was rejected. Instead, we confirmed a close correlation to postconceptional age, supporting a genetically programmed switch, insensitive to most environmental factors including birth.
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| 3. |
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| 4. |
- Klemming, Stina, et al.
(författare)
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Mother-newborn couplet care : Nordic country experiences of organization, models and practice
- 2023
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Ingår i: Journal of Perinatology. - : Springer Nature. - 0743-8346 .- 1476-5543. ; 43:SUPPL 1, s. 17-25
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Tidskriftsartikel (refereegranskat)abstract
- Mother-Newborn Couplet Care is a concept and is defined as the provision of care for a sick or preterm newborn in close proximity to and coupled with the care for the mother from the birth of the infant and for as long as the mother needs hospital care. This concept of care requires system change in both obstetrics and pediatrics in terms of the planning and organization of care, equipment and design of units. Accordingly, strong leadership setting clear goals and emphasizing a culture of cohesive care, supported by targeted education and training is crucial to ensure high-quality care of all mother-newborn dyads without separation. We describe various organizational models of Mother-Newborn Couplet Care used in Sweden and Finland and implementation processes. We envision a future where newborns and mothers are always together, irrespective of medical needs, and form an inseparable center around which healthcare services and providers are organized.
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| 5. |
- Lindberg, Josefine, 1991-, et al.
(författare)
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Cardiometabolic risk factors in children born with marginally low birth weight : A longitudinal cohort study up to 7 years-of-age
- 2019
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 14:4
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Low birth weight (LBW, <2500 g) may predict an increased risk of an adverse cardiometabolic profile later in life, but long-term effects in different populations and birth weight strata are still unclear. We explored laboratory markers of cardiometabolic risk in children born with marginally LBW (2000-2500 g). Methods This was a prospective longitudinal cohort study including 285 Swedish marginally LBW children and 95 normal birth weight (NBW, 2501-4500 g) controls. At 3.5 and 7 years of age, blood samples for glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), cholesterol, triglycerides, high-and low density lipoprotein (HDL and LDL), apolipoprotein B (ApoB) and apolipoprotein A1 (ApoA1) were assessed and compared between the groups. Results No significant differences in levels of insulin, HOMA-IR, hs-CRP or blood lipids were observed between marginally LBW and NBW children. At 7 years there was a higher proportion of marginally LBW children with elevated levels of insulin, defined as above the 90th percentile of the control group (21% vs 8.6%, p = 0.038). This association was, however, confounded by maternal ethnicity. In marginally LBW children born small for gestational age (SGA), mean fasting glucose was significantly higher compared to controls (4.7 vs 4.5 mmol/L, p = 0.020). Conclusions There were no significant differences in insulin, insulin resistance, hs-CRP or blood lipids between the marginally LBW children and controls. The subgroup of marginally LBW children born SGA may present early signs of glucose imbalance already at school age.
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| 6. |
- Raiskila, Simo, et al.
(författare)
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Parent and nurse perceptions on the quality of family-centred care in 11 European NICUs
- 2016
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Ingår i: Australian Critical Care. - : Elsevier BV. - 1036-7314 .- 1878-1721. ; 29:4, s. 201-209
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Family-centred care (FCC) is a state-of-the-art practice in neonatal intensive care units (NICU) based on its shown benefits on the well-being of both infants and parents. However, there is no systematic knowledge about how FCC is implemented in different European contexts. OBJECTIVES: To describe parents' presence and the quality of FCC from the perspectives of mothers, fathers and nurses in 11 European NICUs. METHODS: A prospective survey was conducted in Finland, Sweden, Norway, Estonia, Spain and Italy. The perceived quality of FCC was measured using 8 text-message questions sent to the parents' mobile phones, one question each day, during the infant's hospital stay. Nurses answered corresponding questions through a Web questionnaire during a 3-month period. The responses were rated on a 7-point Likert scale. Parents who were not present in the unit during the day used a "0" response. RESULTS: A total of 262 families of preterm infants born before 35 gestational weeks participated in the study. Mothers gave 5045 responses, fathers gave 3971 responses and nurses gave 11,132 answers. The mothers were present during 92.7% and the fathers during 77.9% of the study days. The mothers rated the quality of FCC slightly higher than the fathers did (5.8 [95% CI 5.7-5.9] vs. 5.7 [95% CI 5.6-5.8], mean difference of 0.12 [95% CI 0.05-0.2], p<0.001). There was wide variation in the parents' presence and the quality of FCC between the units. The weakest aspects of FCC were emotional support, parents' participation in decision-making and fathers' participation in infant care. The perceived quality of FCC between the nurses and parents were comparable. CONCLUSIONS: This study showed a high perceived quality of FCC in 11 European units, as indicated by both parents and nurses. The innovative data-collection method and instrument successfully quantified each unit's FCC profile for further quality improvement and should be trialled in other NICUs and countries.
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