| 1. |
- Austeng, Dordi, et al.
(författare)
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Incidence of and risk factors for neonatal morbidity after active perinatal care : extremely preterm infants study in Sweden (EXPRESS)
- 2010
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 99:7, s. 978-992
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of this study was to determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotizing enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage >= 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusion: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted.
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| 2. |
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| 3. |
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| 4. |
- Fellman, Vineta, et al.
(författare)
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One-year survival of extremely preterm infants after active perinatal care in Sweden.
- 2009
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Ingår i: JAMA : the journal of the American Medical Association. - : American Medical Association (AMA). - 1538-3598 .- 0098-7484. ; 301:21, s. 2225-33
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Tidskriftsartikel (refereegranskat)abstract
- Up-to-date information on infant survival after extremely preterm birth is needed for assessing perinatal care services, clinical guidelines, and parental counseling.
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| 5. |
- Hellström, Ann, 1959, et al.
(författare)
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Extreme prematurity, treated retinopathy, bronchopulmonary dysplasia and cerebral palsy are significant risk factors for ophthalmological abnormalities at 6.5years of age
- 2018
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 107:5, s. 811-821
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study evaluated the contributions of various prenatal and postnatal predictive factors to a documented high prevalence of ophthalmological abnormalities in children aged 6.5 years who were born extremely preterm. Methods: We carried out a prospective population-based study of all children born in Sweden at a gestational age of 22+0 to 26+6weeks based on the Extremely Preterm Infants in Sweden Study. The main outcome measures were a combined score of visual impairment, refractive errors and strabismus at 6.5years of age. Models of univariate and multivariable regression were used to analyse potential prenatal and postnatal predictive factors at different clinically relevant time-points from one minute after birth to 30months. Results: We focused on 399 known extremely preterm survivors and compared them to 300 full-term controls. Significant antecedents for ophthalmological abnormalities included prematurity per se, retinopathy of prematurity that required treatment, severe bronchopulmonary dysplasia and cerebral palsy. Severe intraventricular haemorrhage was no longer a significant risk factor when we adjusted it for the 30-month cognitive and neuromotor development outcomes. Conclusion: This time-course risk analysis model showed a changing panorama of significant risk factors for ophthalmological abnormalities in children aged 6.5years who were born extremely preterm.
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| 6. |
- Holmström, Gerd E, et al.
(författare)
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Ophthalmologic Outcome at 30 Months Corrected Age of a Prospective Swedish Cohort of Children Born Before 27 Weeks of Gestation The Extremely Preterm Infants in Sweden Study
- 2014
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Ingår i: JAMA OPHTHALMOLOGY. - : American Medical Association (AMA). - 2168-6165 .- 2168-6173. ; 132:2, s. 182-189
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Follow-up at 30 months corrected age reveals eye and visual problems in one-third of children born extremely prematurely (less than27 weeks gestation). OBJECTIVE To investigate the ophthalmologic outcome of extremely preterm children at 30 months corrected age. DESIGN, SETTING, AND PARTICIPANTS A prospective, population-based follow-up study (Extremely Preterm Infants in Sweden Study [EXPRESS]) was conducted in Sweden. The population included extremely preterm infants (less than27 weeks gestation) born in Sweden between 2004 and 2007, of whom 491 survived until age 2.5 years. Screening for retinopathy of prematurity (ROP) was performed in the neonatal period. At 30 months corrected age, an ophthalmologic assessment was performed in 411 of 491 children (83.7%). MAIN OUTCOMES AND MEASURES Visual acuity, manifest strabismus, and refractive errors were evaluated. RESULTS Visual impairment was identified in 3.1% of the children, and 1.0% were blind. Refractive errors, defined as myopia less than -3 diopters (D), hypermetropia greater than +3 D, astigmatism 2 D or more, and/or anisometropia 2 D or more, were found in 25.6% of the children, and 14.1% had manifest strabismus. There were significant associations between visual impairment and treated ROP (P = .02), cognitive disability (P less than .001), and birth weight (P = .02). Multiple regression analyses revealed significant associations between strabismus and treated ROP (P less than .001), cognitive disability (P less than .01), and cerebral palsy (P = .02). Refractive errors were significantly correlated with severity of ROP (right eye, P less than .001; left eye, P less than .01). Children who had been treated for ROP had the highest frequency (69.0%) of eye and visual abnormalities. CONCLUSIONS AND RELEVANCE One-third of the extremely prematurely born children in this study had some kind of eye or visual problems, such as visual impairment, strabismus, or major refractive error. Despite being born extremely preterm, the present cohort has a similar prevalence of blindness and visual impairment as in previous Swedish cohorts of children born less prematurely.
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| 7. |
- Månsson, Johanna, et al.
(författare)
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Agreement Between Bayley-III Measurements and WISC-IV Measurements in Typically Developing Children
- 2019
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Ingår i: Journal of Psychoeducational Assessment. - : Sage Publications. - 0734-2829 .- 1557-5144. ; 37:5, s. 603-616
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Tidskriftsartikel (refereegranskat)abstract
- The study aim was to explore the relationship between a developmental assessment at preschool age and an intelligence quotient (IQ) assessment at school age. One hundred sixty-two children were assessed at 2.5 years with the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) and then at 6.5 years with the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV). The Bayley-III Cognitive Index score was the Bayley entity that showed the highest correlation with WISC-IV Full-Scale IQ (FSIQ; r = .41). There was a significant difference between the individual WISC-IV FSIQ and the Bayley-III Cognitive Index scores. Analyses showed an average difference of -4 units and 95% limits of agreement of -18.5 to 26.4 units. A multivariate model identified the Bayley-III Cognitive Index score as the most important predictor for FSIQ and General Ability Index (GAI), respectively, in comparison with demographic factors. The model explained 24% of the total FSIQ variation and 26% of the GAI variation. It was concluded that the Bayley-III measurement was an insufficient predictor of later IQ.
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| 8. |
- Månsson, Johanna, et al.
(författare)
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The ability of Bayley-III scores to predict later intelligence in children born extremely preterm
- 2021
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 110:11, s. 3030-3039
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Tidskriftsartikel (refereegranskat)abstract
- Aim To investigate the ability of the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III), scores to predict later Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), performances in a cohort of children born extremely preterm. Methods 323 children, born <27 gestational weeks, were tested with the Bayley-III at corrected age 2.5 years and with the WISC-IV at 6.5 years. Regression analyses investigated the association between Bayley-III scores and WISC-IV full-scale intelligence quotient (IQ). The ability of Bayley-III Cognitive Index scores to predict low IQ was evaluated using receiver operating characteristic curves. Results Bayley-III Cognitive Index scores and IQ had a moderately positive correlation and accounted for 38% of the IQ variance. Using a Bayley-III cut-off score of 70, the sensitivity to detect children with IQ<70 was 18%, and false positive rate was 7%. A Bayley-III cut-off score of 85 corresponded to sensitivity and false positive rates of 44% and 7%, respectively. Conclusions Results emphasise the relative importance of Bayley-III Cognitive Index scores as predictors of IQ. An 85 score cut-off for suspecting subnormal IQ is supported. A less conservative threshold would increase identification of true cases yet increase the risk of wrongly diagnosing children.
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| 9. |
- Serenius, Fredrik, 1939-, et al.
(författare)
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Neurodevelopmental outcome in extremely preterm infants at 2.5 years after active perinatal care in Sweden.
- 2013
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Ingår i: Journal of the American Medical Association. - : American Medical Association (AMA). - 0098-7484 .- 1538-3598. ; 309:17, s. 1810-20
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Tidskriftsartikel (refereegranskat)abstract
- Importance Active perinatal care increases survival of extremely preterm infants; however, improved survival might be associated with increased disability among survivors. Objective To determine neurodevelopmental outcome in extremely preterm children at 2.5 years (corrected age). Design, Setting, and Participants Population-based prospective cohort of consecutive extremely preterm infants born before 27 weeks of gestation in Sweden between 2004 and 2007. Of 707 live-born infants, 491 (69%) survived to 2.5 years. Survivors were assessed and compared with singleton control infants who were born at term and matched by sex, ethnicity, and municipality. Assessments ended in February 2010 and comparison estimates were adjusted for demographic differences. Main Outcomes and Measures Cognitive, language, and motor development was assessed with Bayley Scales of Infant and Toddler Development (3rd edition; Bayley-III), which are standardized to mean (SD) scores of 100 (15). Clinical examination and parental questionnaires were used for diagnosis of cerebral palsy and visual and hearing impairments. Assessments were made by week of gestational age. Results At a median age of 30.5 months (corrected), 456 of 491 (94%) extremely preterm children were evaluated (41 by chart review only). For controls, 701 had information on health status and 366 had Bayley-III assessments. Mean (SD) composite Bayley-III scores (cognition, 94 [12.3]; language, 98 [16.5]; motor, 94 [15.9]) were lower than the corresponding mean scores for controls (cognition, 104 [10.6]; P < .001; adjusted difference in mean scores, 9.2 [99% CI, 6.9-11.5]; language, 109 [12.3]; P < .001; adjusted difference in mean scores, 9.3 [99% Cl, 6.4-12.3]; and motor, 107 [13.7]; P < .001; adjusted difference in mean scores, 12.6 [99% Cl, 9.5-15.6]). Cognitive disability was moderate in 5% of the extremely preterm group vs 0.3% in controls (P < .001) and it was severe in 6.3% of the extremely preterm group vs 0.3% in controls (P < .001). Language disability was moderate in 9.4% of the extremely preterm group vs 2.5% in controls (P < .001) and severe in 6.6% of the extremely preterm group vs 0% in controls (P < .001). Other comparisons between the extremely preterm group vs controls were for cerebral palsy (7.0% vs 0.1%; P < .001), for blindness (0.9% vs 0%; P = .02), and for hearing impairment (moderate and severe, 0.9% vs 0%; P = .02, respectively). Overall, 42% (99% CI, 36%-48%) of extremely preterm children had no disability, 31% (99% CI, 25%-36%) had mild disability, 16% (99% CI, 12%-21%) had moderate disability, and 11% (99% CI, 7.2%-15%) had severe disability. Moderate or severe overall disability decreased with gestational age at birth (22 weeks, 60%; 23 weeks, 51%; 24 weeks, 34%; 25 weeks, 27%; and 26 weeks, 17%; P for trend < .001). Conclusions and Relevance Of children born extremely preterm and receiving active perinatal care, 73% had mild or no disability and neurodevelopmental outcome improved with each week of gestational age. These results are relevant for clinicians counseling families facing extremely preterm birth. JAMA. 2013;309(17):1810-1820
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| 10. |
- Serenius, Fredrik, et al.
(författare)
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Neurodevelopmental Outcome in Extremely Preterm Infants at 2.5 Years After Active Perinatal Care in Sweden
- 2013
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Ingår i: Obstetrical and Gynecological Survey. - : Lippincott Williams & Wilkins. - 0029-7828 .- 1533-9866. ; 68:12, s. 781-783
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- A proactive approach to the care of extremely preterm infants has increased survival and lowered the gestational age of viability, but these improvements may be associated with later neurodevelopmental disability. EXPRESS is a national population-based prospective study of all infants born alive or stillborn at less than 27 weeks’ gestation between 2004 and 2007 in Sweden. This prospective follow-up study was undertaken to assess neurologic and developmental outcome of the EXPRESS cohort at 2.5 years corrected age compared with a matched control group born at term.Of 707 live-born infants, 497 (70%) survived to corrected age 2.5 years; the final cohort included 491 children. Each preterm child was matched with 2 control subjects at 2.5 years chronological age. Cognitive, language, and motor development were assessed with the Bayley Scales of Infant and Toddler Development (Bayley III). Cerebral palsy (CP), visual and hearing disability, and a composite outcome of overall disabilities were assessed. The overall outcome was characterized as no, mild, moderate, and severe disability.Of 415 infants assessed with clinical examinations, 399, 393, and 382, respectively, completed the Bayley III cognitive, language, and motor scales; 366 control children were assessed with Bayley III. The mean composite cognitive, language, and motor scores for children in the preterm and control groups were 94 ± 12 and 104 ± 11, respectively (P < 0.001), 98 ± 17 and 109 ± 12 (P < 0.001), respectively, and 94 ± 16 and 107 ± 14 (P < 0.001), respectively. Normal cognitive development or mild cognitive disability was found in 354 preterm children (88.8%) and 364 control children (99.5%). Moderate or severe cognitive disability was present in 20 preterm children (5.0%) and 1 control child (0.3%) (P < 0.001) and in 25 (6.3%) and 1 (0.3%), respectively (P < 0.001). Normal language development or mild language disability was found in 330 children (83.9%) in the preterm group and with 351 (97.5%) in the control group (all group comparisons, P < 0.001). Normal motor development or mild motor disability occurred in 324 (84.8%) and 348 (98.6%) of children in the preterm and control groups, respectively. Moderate or severe mental developmental delay was seen in 88 and 10 children (20% and 2.8%), respectively (P < 0.001).In the preterm group, Bayley III cognitive, language, and motor scores increased with advancing gestational age at birth by 2.5 points (99% confidence interval [CI], 1.0–4.0) per week (P < 0.001), by 3.6 points (99% CI, 1.6–5.6) per week (P < 0.001), and by 2.5 points (99% CI, 0.5–4.5) per week scores (P = 0.001), respectively. Cerebral palsy was present in 32 preterm children (7.0%; 99% CI, 3.9–10.1%). Of 456 preterm children, 42.1% were classified as normal, 30.7% as having mild disabilities, and 27.2% as having moderate or severe disabilities (vs 78.1%, 18.6%, 3.3% of control subjects, respectively; P < 0.001 for all comparisons). The proportion of children with mild or no disabilities increased from 40% at 22 weeks to 83% at 26 weeks (P < 0.001 for trend). Moderate or severe disabilities decreased from 60% at 22 weeks to 17% at 26 weeks (P < 0.001 for trend).The impact of prematurity on neurodevelopmental outcome indicates that further improvements in neonatal care are necessary. Although preterm children had poorer neurodevelopmental outcomes than those born at term, 73% had no or mild disability, and neurodevelopmental outcome improved with each week of gestational age. These results are relevant for clinicians counseling couples facing extremely preterm birth of their infant
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| 11. |
- Serenius, Fredrik, et al.
(författare)
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Neurodevelopmental Outcomes Among Extremely Preterm Infants 6.5 Years After Active Perinatal Care in Sweden
- 2016
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Ingår i: Jama Pediatrics. - Chicago : American Medical Association (AMA). - 2168-6203 .- 2168-6211. ; 170:10, s. 954-963
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Active perinatal care increases the rate of survival of extremely preterm infants, but there are concerns that improved survival might increase the rate of disabled survivors. OBJECTIVE To determine the neurodevelopmental outcomes of a national cohort of children 6.5 years of age who had been born extremely preterm (<27 weeks' gestational age) in Sweden. DESIGN, SETTING, AND PARTICIPANTS Population-based prospective cohort study of consecutively born extremely preterm infants. All of these infants were born in Sweden during the period from April 1, 2004, to March 31, 2007. Of 707 live-born extremely preterm infants, 486 (68.7%) survived to 6.5 years of age. These children were assessed and compared with matched controls who had been born at term. Comparison estimates were adjusted for demographic differences. Assessments ended in February 2014, and analysis started thereafter. MAIN OUTCOMES AND MEASURES Cognitive ability was measured with the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV), and the mean (SD) scores of the children who had been born extremely preterm were compared with those of the controls. Clinical examinations and parental questionnaires were used for diagnosis of cerebral palsy, hearing and vision impairments, and cognition for the children who were not assessed with the WISC-IV. RESULTS Of 486 eligible infants who were born extremely preterm, 441 (90.7%) were assessed at 6.5 years of age (59 by medical record review only) alongside 371 controls. The adjusted mean (SD) full-scale WISC-IV score was 14.2 (95% CI, 12.1-16.3) points lower for children who had been born extremely preterm than for controls. Cognitive disability was moderate for 18.8% of extremely preterm children and 2.2% of controls (P < .001), and it was severe for 11.1% of extremely preterm children and 0.3% of controls (P < .001). Cerebral palsy was observed in 9.5% of extremely preterm children and 0.0% of controls (P < .001), blindness was observed in 2.0% of extremely preterm children and 0.0% of controls (P < .001), and hearing impairment was observed in 2.1% of extremely preterm children and 0.5% of controls (P = .07). Overall, 36.1%(95% CI, 31.7%-40.6%) of extremely preterm children had no disability, 30.4%(95% CI 26.3%-34.8%) had mild disability, 20.2%(95% CI, 16.6%-24.2%) had moderate disability, and 13.4%(95% CI, 10.5%-16.9%) had severe disability. For extremely preterm children, moderate or severe overall disability decreased with gestational age at birth (adjusted odds ratio per week, 0.65 [95% CI, 0.54-0.79]; P < .001) and increased from 26.6% to 33.5%(P = .01) for children assessed both at 2.5 and 6.5 years. CONCLUSIONS AND RELEVANCE Of the 441 extremely preterm infants who had received active perinatal care, 293 (66.4%) had no or mild disability at 6.5 years; of the 371 controls, 11 (3.0%) had moderate or severe disability. Disability rates at 6.5 years increased relative to the rates at 2.5 years. Results are relevant for health care professionals and planners, and for clinicians counseling families facing extremely preterm births.
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| 12. |
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| 13. |
- Andersson, Ola, et al.
(författare)
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Effect of Delayed Cord Clamping on Neurodevelopment at 4 Years of Age : A Randomized Clinical Trial
- 2015
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Ingår i: JAMA pediatrics. - : American Medical Association (AMA). - 2168-6203 .- 2168-6211. ; 169:7, s. 631-638
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Prevention of iron deficiency in infancy may promote neurodevelopment. Delayuci umbilical cord clamping (CC) prevents iron deficiency at 4 to 6 months of age, but long-term effects after 12 months of age have not been reported. OBJECTIVE To investigate the effects of delayed CC compared with early CC on neurodevelopment at 4 years of age. DESIGN, SETTING, AND PARTICIPANTS Follow-up of a randomized clinical trial conducted from April 16, 2008, through May 21, 2010, at a Swedish county hospital. Children who were included in the original study (n = 382) as full-term infants born after a low-risk pregnancy were invited to return for follow-up at 4 years of age. Wechsler Preschool and Primary Scale of Intelligence (WPPSI-111) and Movement Assessment Battery for Children (Movement ABC) scores (collected between April 18, 2012, and July 5, 2013) were assessed by a blinded psychologist. Between April 11, 2012, and August 13, 2013, parents recorded their child's development using the Ages and Stages Questionnaire, Third Edition (ASQ) and behavior using the Strengths and Difficulties Questionnaire. All data were analyzed by intention to treat. INTERVENTIONS Randomization to delayed CC (>= 180 seconds after delivery) or early CC (<= 10 seconds after delivery). MAIN OUTCOMES AND MEASURES The main outcome was full-scale IQ as assessed by the were development as assessed by the scales from the WPPSI-III and Movement ABC, development as recorded using the ASQ, and behavior using the Strengths and Difficulties Questionnaire. RESULTS We assessed 263 children (68.8%). No differences were found in WPPSI-III scores between groups. Delayed CC improved the adjusted mean differences (AMDs) in the ASQ personal-social (AMD, 2.8; 95% Cl, 0.8-4.7) and fine-motor (AMD, 2.1; 95% Cl, 0.2-4.0) domains and the Strengths and Difficulties Questionnaire prosocial subscale (AMD, 0.5; 95% Cl, >0.0-0.9). Fewer children in the delayed-CC group had results below the cutoff in the ASQ fine-motor domain (11.0% vs 3.7%; P =.02) and the Movement ABC bicycle-trail task (12.9% vs 3.8%; P =.02). Boys who received delayed CC had significantly higher AMDs in the WPPSI-III processing-speed quotient (AMD, 4.2; 95% Cl, 0.8-7.6; P =.02), Movement ABC bicycle-trail task (AMD, 0.8; 95% Cl, 0.1-1.5; P =.03), and fine-motor (AMD, 4.7; 95% Cl, 1.0-8.4; P =.01) and personal-social (AMD, 4.9; 95% Cl, 1.6-8.3; P =.004) domains of the ASQ. CONCLUSIONS AND RELEVANCE Delayed CC compared with early CC improved scores in the fine-motor at 4 years of age, especially in boys, indicating that optimizing the time to CC may affect neurodevelopment in a low-risk population of children born in a high-income country.
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| 14. |
- Bolk, Jenny, et al.
(författare)
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National population-based cohort study found that visual-motor integration was commonly affected in extremely preterm born children at six-and-a-half years
- 2018
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Ingår i: Acta Paediatrica. - : WILEY. - 0803-5253 .- 1651-2227. ; 107:5, s. 831-837
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study aimed to explain the relationship between visual-motor integration (VMI) abilities and extremely preterm (EPT) birth, by exploring the influence of perinatal variables, cognition, manual dexterity and ophthalmological outcomes. Methods: This was part of the population-based national Extremely Preterm Infant Study in Sweden (EXPRESS) study. We studied 355 children, born at a gestational age of <27 weeks from April 2004 to March 2007, and 364 term-born controls. At six-and-a-half years of age, we assessed VMI, cognitive function, motor skills and vision. VMI impairment was classified as <-1 standard deviation (SD). Results: The mean (SD) VMI score was 87 (+/- 12) in preterm children compared to 98 (+/- 11) in controls (p < 0.001). VMI impairment was present in 55% of preterm infants and in 78% of children born at 22-23 weeks. Male sex and postnatal steroids showed a weak association with poorer visual-motor performance, whereas low manual dexterity and cognitive function showed a stronger association. Conclusion: Poor VMI performance was common in this EXPRESS cohort of children born EPT. Its strong association to cognition and manual dexterity confirms that all of these factors need to be taken into account when evaluating risks in preterm born children.
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| 15. |
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| 16. |
- Brogårdh-Roth, Susanne, et al.
(författare)
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Dental anxiety patterns in adolescents born preterm compared with matched controls
- 2009
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Ingår i: International Journal of Paediatric Dentistry. - 0960-7439 .- 1365-263X. ; 19:Supplement 1, s. 66-170
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction A high frequency of cognitive and behavioural disturbances has been reported in preterm children. It is not known if this affects the children’s apperceptions or behaviours during dental treatment. The aim was therefore to investigate dental behavioural management problems (BMP) and dental anxiety (DA) in preterm children from age 3-14, and to compare with matched controls. Materials and Methods 187 preterm children (23-32 weeks of gestation), born 1994-96 were followed regarding BMP and DA. Comparisons were made with matched full-term controls. Data on BMP were collected from dental records for the ages 3 and 6 yrs. During the school years, parents were interviewed twice regarding BMP in their children. Two periods of time were covered; preschool period, and early school years. Finally, at 12-14 yrs the children filled out the CFSS-DS scale, measuring DA. Results During pre-school years pre-term children showed significantly more BMP at various kinds of dental treatments (32% vs. 15%; p<0.001). This was confirmed in the first interviews of the parents (20%vs. 10%; p=0.028). At the second interviews, covering early school years, no differences were found between the groups. This was also verified by the children’s scorings on CFSS-DS at age 12-14 where no differences in mean scores were revealed. Conclusion Children born preterm seem to have a high prevalence of BMP during preschool years. But this difference decreases with increasing age, possibly reflecting a catch-up. At school years and early adolescence no differences were seen between the groups regarding BMP or DA.
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| 17. |
- Brogårdh-Roth, Susanne, et al.
(författare)
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Dental behavioural management problems and dental caries prevalence in 3-to 6-year-old Swedish children born preterm
- 2008
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Ingår i: International Journal of Paediatric Dentistry. - 0960-7439 .- 1365-263X. ; 18:5, s. 341-347
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Tidskriftsartikel (refereegranskat)abstract
- Background. Today, most children born preterm survive without major impairments. But high frequencies of cognitive and behavioural difficulties arise. Studies on dental behavioural management problems (DBMP) in these children are lacking. In addition, studies on caries prevalence are few and inconclusive. Aim. This study aims to compare the frequency of behavioural problems and poor compliance with dental treatment in preschool children born preterm with those born full-term. The prevalence of caries was also studied. Methods. The study group included 187 children born between 23 and 32 weeks of gestation. The control group constituted full-term children matched by age, sex, immigrant background, and dental operator. DBMP, number of dental visits, missed appointments, and caries between ages 3 and 6 were noted. Results. At age 3, but not at age 6, the prevalence of DBMP at clinical examinations was significantly higher in preterm children compared with the control group. Of the children who received dental treatments during preschool years, preterm children displayed significantly more DBMP. No significant difference in dental visits or in caries prevalence was found. Preterm children, however, missed significantly more dental appointments. Conclusion. Children born preterm display a higher prevalence of DBMP at dental examinations and treatments during preschool years.
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| 18. |
- Brogårdh-Roth, Susanne, et al.
(författare)
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Dental fear and anxiety and oral health behaviour in 12-to-14-year-olds born preterm
- 2010
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Ingår i: International Journal of Paediatric Dentistry. - 0960-7439 .- 1365-263X. ; 20:6, s. 391-399
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: An enhanced frequency of cognitive and behavioural disturbances has been reported in preterm children. It is not known if this affects their perceptions of or behaviour in the dental care situation. HYPOTHESIS: The hypotheses were that preterm (PT) children aged 12-14 years more often exhibit dental fear and anxiety (DFA) than full-term controls (C), while no differences were expected regarding oral health behaviour. METHODS: One hundred and nine PT and 108 C children took part in the present questionnaire study. DFA was assessed using the Children's Fear Survey Schedule - Dental Subscale (CFSS-DS). In addition the questionnaire covered items including satisfaction with received dental care, oral health behaviour and medical health. RESULTS: The children's CFSS-DS scores revealed no differences between the PT and C groups. Regarding oral health behaviour there were no differences, except that PT children more often used dental floss and extra fluoride supplements. PT children reported more medical health problems than C children. CONCLUSIONS: Preterm (PT) children 12- to 14-years-old, as well as C of same age group, seem to be satisfied with their dental care and display low prevalence of DFA. Still, a higher frequency of medical health problems in the PT children suggests that these children should be regarded as potential risk patients for oral health problems.
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| 19. |
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| 20. |
- Brogårdh-Roth, Susanne, et al.
(författare)
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Parental perspectives on preterm children's oral health behaviour and experience of dental care during preschool and early school years
- 2009
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Ingår i: International Journal of Paediatric Dentistry. - 0960-7439 .- 1365-263X. ; 19:4, s. 243-250
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Tidskriftsartikel (refereegranskat)abstract
- Background. Children born preterm (PT) have medical conditions and impairments that may affect their oral health. Hypothesis. Our hypothesis for the study was that PT children display more dental behaviour management problems (BMPs) and less favourable oral health behaviour than controls (C). Methods. Parents of 153 PT children and 153 C children were interviewed regarding the children's oral health behaviour and experience of dental care on two occasions, 2 years apart. The interviews concerned the preschool period and the early school years, respectively. Results. BMPs were more common in PT children of preschool age, but not during the early school years. Regarding oral health behaviour, there were no differences between the groups, except that PT children had more problems with toothbrushing than C children in the preschool period, in spite of the fact that the PT group reported more medical health problems and more anxious behaviour and indications of cognitive problems than the C group. Conclusions. Children born PT exhibit several risk factors for both BMP and impaired oral health. It is essential that this group of patients is identified early and receives special attention from the dental services.
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| 21. |
- Dykes, K, et al.
(författare)
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The importance of ultrasound of primagravidae’s thoughts about their unborn child
- 2001
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Ingår i: Journal of Reproductive and Infant Psychology. - : Informa UK Limited. - 0264-6838 .- 1469-672X. ; 19:2, s. 95-104
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Tidskriftsartikel (refereegranskat)abstract
- Evaluated the importance of ultrasound to women’s thoughts about their unborn child. 10 first-time mothers (ages 22 – 33 years) with normal pregnancies were interviewed approxi¬mately 1 week before and 1 week after their first ultrasound screening. Analysis of the interviews was conducted using the techniques of grounded theory. The results show that ultrasound was of great importance for increasing the women’s awareness of bearing a child. This realization process was expressed in various categories of thoughts about the unborn child: 1. The existing fetus, 2. The coming child, 3. The woman’s life situation, 4. Parenthood and 5. Delivery. The paper examined the way in which ultrasound influences these categories of thought.
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| 22. |
- Hallböök, Tove, et al.
(författare)
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Vagus nerve stimulation in 15 children with therapy resistant epilepsy; its impact on cognition, quality of life, behaviour and mood.
- 2005
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Ingår i: Seizure. - : Elsevier BV. - 1532-2688 .- 1059-1311. ; 14:Feb 19, s. 504-513
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Vagus nerve stimulation (VNS) is a neurophysiologic treatment for patients with refractory epilepsy. There is growing evidence of additional quality of life (QOL) benefits of VNS. We report the effects of VNS on seizure frequency and severity and how these changes are related to cognitive abilities, QOL, behaviour and mood in 15 children with medically refractory and for surgery not eligible epilepsy. METHODS: Initially, and after 3 and 9 months of VNS-treatment, 15 children were investigated with Bayley Scales of Infant Development (BSID), Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R), Wechlser Intelligence Scales for Children (WISC-III) depending on the child's level of functioning, a Visual Analogue Scale for validating QOL, Child Behaviour Checklist (CBCL) for quantifying behaviour problems, Dodrill Mood Analogue Scale and Birleson Depression Self-Rating Scale, and the National Hospital Seizure Severity Scale (NHS3). A diary of seizure frequency was collected. RESULTS: Six of 15 children showed a 50% or more reduction in seizure frequency; one of these became seizure-free. Two children had a 25-50% seizure reduction. Two children showed increased seizure frequency. In 13 of 15 children there was an improvement in NHS3. The parents reported shorter duration of seizure and recovery phase. There were no changes in cognitive functioning. Twelve children showed an improvement in QOL. Eleven of these also improved in seizure severity and mood and five also in depressive parameters. CONCLUSION: This study has shown a good anti-seizure effect of VNS, an improvement in seizure severity and in QOL and a tendency to improvement over time regarding behaviour, mood and depressive parameters. The improvement in seizure severity, QOL, behaviour, mood and depressive parameters was not related to the anti-seizure effect.
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| 23. |
- Hallin, Anne-Li, et al.
(författare)
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Adolescents born extremely preterm: behavioral outcomes and quality of life
- 2011
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Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 1467-9450 .- 0036-5564. ; 52, s. 251-256
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Tidskriftsartikel (refereegranskat)abstract
- Hallin, A.-L., Stjernqvist, K. (2010). Adolescents born extremely preterm: behavioral outcomes and quality of life. Scandinavian Journal of Psychology. Fifty-two extremely premature born and 54 full-term controls were assessed regarding behavioral outcomes, risk-taking and self-perceived quality of life. Behavioral outcomes were assessed with the Achenbach Youth Self Report; risk-taking was estimated regarding alcohol and nicotine use; self-perceived quality of life and future expectations were rated; and attention and hyperactivity problems were surveyed retrospectively with the Wender Utah Rating Scale. The prematurely born reported fewer problems than full-term born on the externalizing scale (delinquent behavior and aggressive behaviour); and they reported less alcohol consumption. No difference was observed between the two groups concerning nicotine use, views about quality of life and expectations for the future or in the retrospective assessment of attention and hyper-activity problems. Conclusively, the prematurely born adolescents described a quality of life and future expectations comparable to full-term born controls. They also reported fewer behavioral problems and less risk-taking behavior.
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| 24. |
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| 25. |
- Hallin, Anne-Li, et al.
(författare)
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Follow-up of adolescents born extremely preterm : cognitive function and health at 18 years of age
- 2010
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 99:9, s. 1401-1406
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To compare cognitive ability, school achievement and self-perceived health aspects in adolescents born extremely preterm and term born controls. Method: Fifty-two, out of 61, extremely preterm born adolescents (mean age 18.4 years) and 54 matched controls (mean age 18.3 years) born at full term were investigated; intelligence quotient was measured with the Wechsler Adult Intelligence Scale; cognitive flexibility, i.e. a measure of visuomotor speed and attention, with the Trail Making Test; school achievement and choice of upper secondary programmes were reported. Health aspects were investigated in a semi structured interview. Result: The adolescents born prematurely had significantly lower IQ than the controls, mean 93 (SD 15.4) vs 106 (12.5), p < 0.001; showed slower visuomotor speed; had lower grades from compulsory school (192.7 vs 234.8, p < 0.001); and chose to a greater extent practical upper secondary school programmes. There were no differences between the groups in health care consumption, prevalence of chronic disease, allergy or infectious diseases. Conclusion: Poorer cognitive performance, in extremely preterm born individuals, seems to persist into late adolescence. Fewer prematurely born than control chose theoretical upper secondary school programmes. However, no difference was noted regarding self-perceived health aspects.
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