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- Hermansson, Liselotte, 1954-, et al.
(författare)
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Upper limb deficiencies in Swedish children : a comparison between a population-based and a clinic-based register
- 2001
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Ingår i: Early Human Development. - 0378-3782 .- 1872-6232. ; 63:2, s. 131-144
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To validate information in the Swedish Register for Congenital Malformations (SRCM).METHODS: A comparison was made with a clinic-based register kept at the Limb Deficiency and Arm Prosthesis Centre (LDAPC). The report frequency and the quality of the information in SRCM were analysed. Cases were classified according to a detailed, clinically relevant classification, the ISO 8548-1:89 method.OUTCOME MEASURES: The completeness of SRCM was first estimated. The Kappa statistic was then used to assess the agreement between the two registers regarding individual categories and across all categories.RESULTS: For the period 1973-1987, we found 125 cases of upper limb reduction deficiencies (ULRD) in the clinic-based register, of which 117 was found in the national register. The completeness of SRCM was thus estimated to be 94% (95% confidence interval 89-98%). The inter-register agreement varied from almost perfect agreement in laterality of deficiency (Kappa 0.98) to substantial agreement in type and level of deficiency (Kappa 0.72-0.79). For specific levels of transverse deficiency, however, the agreement varied between -0.05 and 0.66.CONCLUSIONS: The results indicate that SRCM, with its calculated underestimation of 6%, can be used for studying the prevalence of ULRD in Sweden. However, as SRCM is a surveillance register, the quality of some information seems to be low, making detailed description of cases difficult. Use of the population register data for clinical purposes could therefore result in lower validity. Additional information and follow-up of specific cases are therefore recommended.
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| 2. |
- Sommerfelt, K, et al.
(författare)
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Behavior in term, small for gestational age preschoolers
- 2001
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Ingår i: Early Human Development. - 0378-3782 .- 1872-6232. ; 65:2, s. 107-121
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To evaluate whether being born small for gestational age (SGA) was associated with an increased frequency of preschool behavioral problems. Study design: Follow-up study at 5 years of age. Subjects: A population based cohort of 318 term infants who were SGA, defined as having a birthweight less than the 15th percentile for gestational age, and without major handicap such as cerebral palsy or mental retardation, and a random control sample of 307 appropriate for gestational age (AGA) infants. Outcome measures: The Personality Inventory for Children and the Yale Children's Inventory (completed by the mothers), and child behavior during psychometric testing. Results: Behavior problems was not more common among the SGA children. The results were not confounded by a wide range of parental demographic and child rearing factors, including maternal non-verbal problem solving abilities, child rearing style, and maternal psychological distress. However, the parental factors explained 13% of the variance in a summary score of child behavior compared to 1% explained by SGA vs. AGA status. The SGA children were not more sensitive to the negative impacts of parental risk factors than AGA controls. The study does not address the outcome of severely growth-retarded SGA infants. Conclusion: Being born moderately SGA is not a significant risk factor for preschool behavior problems.
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| 3. |
- Andersson, Yvonne, et al.
(författare)
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Lactoferrin is responsible for the fungistatic effect of human milk.
- 2000
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Ingår i: Early Human Development. - 0378-3782 .- 1872-6232. ; 59:2, s. 95-105
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Tidskriftsartikel (refereegranskat)abstract
- Human milk has recognized anti-microbial effects and it has been repeatedly shown that breast-fed infants have fewer and less severe infections than formula-fed infants. While most studies have focused on anti-bacterial and anti-viral activities few have focused on the anti-fungal effect of human milk. Dermal and other infections caused by fungi are common in very low birth weight (VLBW) infants. Using a liquid culturing method and Candida albicans and Rhodotorula rubra as representative fungi, we studied the anti-fungal effect of human milk and certain human milk proteins. In vitro, human milk showed potent inhibitory effect on fungal growth. Most, if not all of this effect was caused by lactoferrin via its iron-binding capacity; increasing the iron content of the incubation medium abolished the inhibitory effect. In contrast, other human milk proteins with known or suggested anti-microbial effects rather increased fungal growth. Viability test and electron microscopy revealed that the growth inhibitory effect of human milk, i.e. mediated by lactoferrin, is fungistatic rather than fungicidal.
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| 4. |
- Gradin, Maria, et al.
(författare)
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Feeding and oral glucose : additive effects on pain reduction in newborns
- 2004
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Ingår i: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 77:1-2, s. 57-65
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aims of this study were to compare the pain reducing effect of oral glucose with that of being breast-fed shortly before venipuncture in newborns, and also the pain score and crying time with parents' assessment.Design: Randomised, controlled trial.Subjects: 120 full term newborns undergoing venipuncture randomly assigned to on of four groups: I, Breast-fed and 1-ml placebo; II, Breast-fed and 1-ml 30% glucose; III, Fasting and 1-ml placebo; and IV, Fasting and 1-ml 30% glucose.Outcome measures: Pain during venipuncture was measured with the Premature Infant Pain Profile (PIPP). Crying time was recorded. The parents assessed their babies' pain on a Visual Analogue Scale (VAS).Results: The PIPP score was significantly lower in the infants receiving glucose, than in those not given glucose (p=0.004). There was no significant difference in PIPP score between the infants who were fed and the fasting infants. The PIPP score was lower in group II (median 7) than in group I (md 10). There was a similar difference between group IV (md 9) and group III (md 11). The median crying times during the first 3 min in groups I, II, III, and IV were 63, 18, 142 and 93 s, respectively. There was low agreement between the parents' assessment of pain and the PIPP score and crying time.Conclusion: Breast-feeding shortly before venipuncture has no major impact on the pain score but on crying time. The combination of oral glucose and breast-feeding shows the lowest pain score and significantly shorter duration of crying.
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| 10. |
- Dubiel, M, et al.
(författare)
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Evaluation of fetal circulation redistribution in pregnancies with absent or reversed diastolic flow in the umbilical artery
- 2003
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Ingår i: Early Human Development. - 1872-6232. ; 71:2, s. 149-156
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To record blood flow velocimetry in the superior mesenteric, hepatic and middle cerebral arteries for detection of circulation redistribution and prediction of perinatal outcome in fetuses with absent or reversed diastolic flow in the umbilical artery. Study design: The fetal superior mesenteric, hepatic and middle cerebral artery blood velocimetry was recorded in 33 pregnancies complicated by pregnancy-induced hypertension and/or intra-uterine growth retardation between 27 and 41 weeks of gestation. Uterine artery and umbilical vein velocimetries were also recorded. Results: An abnormal mesenteric artery pulsatility, index (PI) was found in four cases; two newborns died due to prematurity, growth retardation and necrotizing enterocolitis. An abnormal fetal hepatic artery PI was found in 17 cases. The brain-sparing effect in the middle cerebral artery was found in 16 cases; three newborns died after delivery. Signs of redistribution in mesenteric, hepatic and middle cerebral artery velocimetry were not related to most of the perinatal outcome variables. Umbilical vein velocimetry correlated with low arterial and venous pH. All perinatal mortalities had umbilical venous pulsations. Conclusions: Signs of visceral circulation redistribution could not predict adverse outcome. Umbilical venous pulsations were, however, seen in nearly all fetuses; this was the only variable suggesting adverse outcome in the present study of severely compromised fetuses. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.
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| 11. |
- Gardiner, Helena, et al.
(författare)
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Ventriculo-vascular interaction in the normal development of the fetal circulation
- 2001
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Ingår i: Early Human Development. - 1872-6232. ; 65:2, s. 97-106
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To examine cardiovascular physiology in the healthy fetus during normal development. DESIGN: Twenty normal fetuses were studied longitudinally from 20 weeks to term. Serial echocardiography was performed, and arterial and venous diameter pulse wave characteristics and aortic pulse wave propagation velocity (PWV) were examined in the thoracic descending aorta (AoD) and inferior caval vein (IVC) using an ultrasonic phase-locked echo-tracking system. Statistical analyses included ANOVA, paired t-test and logistic regression where appropriate. RESULTS: Aortic PWV, maximum incremental and late decremental velocities increased with gestation while the relative pulse amplitude decreased, reflecting falling distal impedance. There was a linear increase in cardiac preload and relative pulse amplitude in the IVC with gestation that correlated significantly with the presence of end-diastolic flow in the pulmonary artery and improvement in right ventricular diastolic function. CONCLUSIONS: Non-invasive concurrent assessment of preload, ventricular function and impedance are possible in the fetus and may prove useful in the longitudinal study of fetal adaptation to pathophysiological changes.
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| 16. |
- Tideman, Eva
(författare)
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Longitudinal follow-up of children born preterm: cognitive development at age 19
- 2000
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Ingår i: Early Human Development. - 1872-6232. ; 58:2, s. 81-90
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Tidskriftsartikel (refereegranskat)abstract
- In a long-term prospective study, 39 preterm children born before 35 completed weeks of gestation and 23 full-term children were followed up at 4, 9 and 19 years of age. Psychometric evaluation of the cognitive development at 4 years of age showed that the preterms fell within the normal range, although their performance was inferior to that of the full-terms. This difference between the groups was not found at 9 and 19 years of age. Within the preterm group there was no correlation between the test results and birthweight, gestational age, prenatal or perinatal optimality scores. Full-terms had better scholastic performance at the end of compulsory schooling, while there was no difference at 19 years of age. At 19 years of age, about 1/3 of the children in both groups rated themselves as having had attention deficits during their childhood and adolescence. In this group of moderately immature, low-risk children, preterm birth without major physical or mental disabilities poses a developmental risk that seems to have the greatest impact during the preschool years and then gradually attenuates.
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| 17. |
- Tideman, E, et al.
(författare)
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Longitudinal follow-up of children born preterm : somatic and mental health, self-esteem and quality of life at age 19
- 2001
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Ingår i: Early Human Development. - 1872-6232. ; 61:2, s. 97-110
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Tidskriftsartikel (refereegranskat)abstract
- In a long-term prospective study, 39 preterm children born before 35 completed weeks of gestation and 23 full-term children were followed up at 19 years of age. Information about somatic and mental health was obtained through interviews and confirmed by medical records. Self-esteem and quality of life were assessed from the subjects' perspective. Significantly more preterms than full-terms had somatic health problems, both during childhood and adolescence and also at age 19. A wide spectrum of diagnoses was represented. Preterms with moderately severe somatic problems also showed signs of psychological distress. The frequency of mental health problems did not differ between the groups. Preterms and full-terms had similarly positive scores regarding self-esteem and quality of life. Altogether, the results indicate that apart from some vulnerability regarding physical health, this group of moderately immature subjects born preterm seems to function as well as young adults in general in important domains of life.
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| 18. |
- Westrup, Björn, et al.
(författare)
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Indications of improved cognitive development at one year of age among infants born very prematurely who received care based on the Newborn Individualized Developmental Care and Assessment Program (NIDCAP)
- 2002
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Ingår i: Early Human Development. - 1872-6232. ; 68:2, s. 83-91
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objective: Care based on the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) has been reported to exert a positive impact on the development of prematurely born infants. The aim of the present investigation was to determine the effect of such care on the 1-year development of infants born with a gestational age of less than 32 weeks. Methods: All surviving infants (11 in the NIDCAP group and 9 in the control group) were assessed employing the Bayley Scales of Infant Development at 1 year of corrected age. Results: The Mental Developmental Index (MDI) of children who had received care according to NIDCAP was higher [88 (72-114)] [median (range)] than the corresponding value for the control children [78 (50-82)] (p = 0.01). The odds ratio for being alive with an MDI > 80 was 14 (95% CI; 1.4-141.5) in favour of the intervention group. However, the Psychomotor Developmental Indices (PDI) were not significantly different [85 (61-108) and 69 (50-114), respectively] (p = 0.23). Conclusion: Our findings indicate that care based on the NIDCAP might have a positive impact on the cognitive development of infants born very prematurely. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
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| 19. |
- Åberg, Anders E, et al.
(författare)
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Congenital malformations among infants whose mothers had gestational diabetes or preexisting diabetes
- 2001
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Ingår i: Early Human Development. - 1872-6232. ; 61:2, s. 85-95
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Diabetes type 1 is associated with an increased risk for infant congenital malformations. It is debated whether this is true also at gestational diabetes. AIMS: To study occurrence of congenital malformations in infants whose mothers had preexisting or gestational diabetes. STUDY DESIGN: A register study covering over 1.2 million Swedish births in 1987-1997 based on the Swedish health registries. SUBJECTS: We identified from the Medical Birth Registry 3864 infants born of women with preexisting diabetes and 8688 infants born of women with gestational diabetes. OUTCOMES MEASURES: Congenital malformations identified in the Medical Birth Registry, the Registry of Congenital Malformations, and the Hospital Discharge Registry. The rates of congenital malformations among these infants was compared with the population rates. RESULTS: At preexisting diabetes, the total malformation rate was 9.5% while the rate at gestational diabetes was similar to the population rate, 5.7%. At preexisting diabetes, certain conditions were more common than expected: orofacial clefts, cardiovascular defects, oesophageal/intestinal atresia, hypospadias, limb reduction defects, spine malformations, and polydactyly. For some of these conditions, an excess was found also for infants whose mothers had gestational diabetes. Infants with multiple malformations were in excess at preexisting diabetes but not at gestational diabetes but the specific type of malformations involved were similar in the two diabetes groups. CONCLUSIONS: It is suggested that in the group of gestational diabetes exists a subgroup with an increased risk for a diabetes embryopathy, perhaps due to preexisting but undetected diabetes type 2.
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