| 1. |
- Oras, Paola, et al.
(författare)
-
A breastfeeding support program changed breastfeeding patterns but did not affect the mothers' self-efficacy in breastfeeding at two months
- 2020
-
Ingår i: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 151
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Even though the biological norm in humans is frequent on demand breastfeeding,sparse feeding intervals have become the cultural norm in most Western countries due to a history of on schedule breastfeeding. This discrepancy between the biological basis and the culturally driven practice continues to interfere with women’s ability to breastfeed.Aim: Our aim was to describe breastfeeding patterns in 2-month-old infants before and after the implementation of a breastfeeding support program. A secondary aim was to investigate the relationship between breastfeeding patterns and the mother’s self-efficacy in breastfeeding.Methods: The study had a baseline/intervention design and was part of a larger project aiming to revive the Ten Steps to Successful Breastfeeding program. The larger project included breastfeeding training for health care professionals and provision of breastfeeding information to parents, including information about on demand breastfeeding. Data were gathered viabreastfeeding diaries (n=79 mothers from each group) and the Breastfeeding Self-efficacy Scale–Short Form (n=83 in the baseline group and n=79 in the intervention group).Results: On demand breastfeeding patterns were more common in the intervention group (97.5%) than in the baseline group (74.7%) (p<0.001), and breastfeeding sessions were more frequent in the intervention group (a median of 14 times per 24 hours versus 11 times in the baseline group; p=0.026). Self-efficacy in breastfeeding did not differ between the groups, but was higher in mothers with exclusive breastfeeding.Conclusions: Knowledge about infants’ breastfeeding behavior can strengthen on demand breastfeeding. Exclusive breastfeeding is associated with higher self-efficacy.
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
- Starke, Veronica, et al.
(författare)
-
Being parents of extremely preterm children, from a long-term perspective : A qualitative study of parents' experiences
- 2023
-
Ingår i: Early Human Development. - : Elsevier. - 0378-3782 .- 1872-6232. ; 183
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn recent decades, modern neonatal intensive care has improved, increasing the survival of extremely preterm children. Few studies have examined the experiences of parents of extremely preterm children from a long-term perspective.AimTo describe parents' experiences of parenting extremely preterm children during their childhood and transition to adulthood.Study designA qualitative interview study with a descriptive design.SubjectsThirteen parents of eleven children born at 24 gestational weeks in Sweden, 1990–1992, participated in individual semi-structured interviews.Outcome measuresData were analyzed using qualitative reflexive thematic analysis.ResultFive themes forming a timeline were created in the analytic process: parenthood, at the NICU, young childhood, adolescence, and adulthood. Various aspects affecting parenthood were described throughout the timeline, and occasionally the parents experienced difficulties dealing with their children's special physical and/or mental needs. Today, some families have established a functioning situation despite their children's physical and/or mental difficulties, while some still struggle with their children's everyday life.ConclusionHaving an extremely preterm family member profoundly affects the whole family for various lengths of time. Parents expressed a need for support from both healthcare and school throughout their children's childhood and in their transition to adulthood, although the need varies between parent–child pairs. By studying the parents' experiences, their need for support can be further recognized and understood, and developed and improved accordingly.
|
|
| 5. |
- Söderström, Fanny, et al.
(författare)
-
Active versus restrictive ligation strategy for patent ductus arteriosus : A retrospective two-center study of extremely preterm infants born between 22 + 0 and 25 + 6 weeks of gestational age
- 2024
-
Ingår i: Early Human Development. - : Elsevier. - 0378-3782 .- 1872-6232. ; 191
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundPatent ductus arteriosus (PDA) in premature infants is associated with adverse clinical outcomes. Mode and timing of treatment are still controversial. Data are limited in the most extremely premature infants <26 weeks of gestational age (GA), where clinical problems are most significant and patients are most vulnerable.AimsTo investigate whether different approaches to surgical closure of PDA in two large Swedish centers has an impact on clinical outcomes including mortality in extremely preterm infants born <26 weeks GA.Study designRetrospective, two-center, cohort study.SubjectsInfants born at 22+0–25+6 weeks GA between 2010 and 2016 at Uppsala University Children's Hospital (UUCH; n = 228) and Queen Silvia Children's Hospital Gothenburg (QSCHG; n = 220).Main outcome measuresSurvival, bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP).ResultsSurgical closure of PDA was more common and performed earlier at QSCHG (50 % vs 16 %; median age 11 vs 44 days; p < 0.01). Survival was similar in both centres. There was a higher incidence of severe BPD and longer duration of mechanical ventilation at UUCH (p < 0.01). There was a higher incidence of ROP, IVH and sepsis at QSCH (p < 0.05, p < 0.01 and p < 0.01). A sub-group analysis matching all surgically treated infants at QSCHG with infants at UUCH with the same GA showed similar results as the total cohort.ConclusionEarlier and higher rate of surgical PDA closure in this cohort of extremely preterms born <26 weeks GA did not impact mortality but was associated with lower rates of severe BPD and higher rates of severe ROP.
|
|
| 6. |
- Söderström, Fanny, et al.
(författare)
-
Active versus restrictive ligation strategy for patent ductus arteriosus - A retrospective two-center study of extremely preterm infants born between 22+0 and 25+6 weeks of gestational age
- 2024
-
Ingår i: EARLY HUMAN DEVELOPMENT. - : Elsevier. - 0378-3782 .- 1872-6232. ; 191
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Patent ductus arteriosus (PDA) in premature infants is associated with adverse clinical outcomes. Mode and timing of treatment are still controversial. Data are limited in the most extremely premature infants <26 weeks of gestational age (GA), where clinical problems are most significant and patients are most vulnerable. Aims: To investigate whether different approaches to surgical closure of PDA in two large Swedish centers has an impact on clinical outcomes including mortality in extremely preterm infants born <26 weeks GA. Study design: Retrospective, two-center, cohort study. Subjects: Infants born at 22(+0)-25(+6) weeks GA between 2010 and 2016 at Uppsala University Children's Hospital (UUCH; n = 228) and Queen Silvia Children's Hospital Gothenburg (QSCHG; n = 220). Main outcome measures: Survival, bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP). Results: Surgical closure of PDA was more common and performed earlier at QSCHG (50 % vs 16 %; median age 11 vs 44 days; p < 0.01). Survival was similar in both centres. There was a higher incidence of severe BPD and longer duration of mechanical ventilation at UUCH (p < 0.01). There was a higher incidence of ROP, IVH and sepsis at QSCH (p < 0.05, p < 0.01 and p < 0.01). A sub -group analysis matching all surgically treated infants at QSCHG with infants at UUCH with the same GA showed similar results as the total cohort. Conclusion: Earlier and higher rate of surgical PDA closure in this cohort of extremely preterms born <26 weeks GA did not impact mortality but was associated with lower rates of severe BPD and higher rates of severe ROP.
|
|
| 7. |
- Söderström, Fanny, et al.
(författare)
-
Early extubation is associated with shorter duration of mechanical ventilation and lower incidence of bronchopulmonary dysplasia
- 2021
-
Ingår i: Early Human Development. - : Elsevier. - 0378-3782 .- 1872-6232. ; 163
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Respiratory care of extremely preterm infants remains a challenge. The majority require invasive mechanical ventilation (MV), which is a contributing factor in developing bronchopulmonary dysplasia (BPD). It is important to keep MV to a minimum but there have been concerns that attempting extubation too early increases the risk for atelectasis, re-intubation, and further lung trauma. The aim of this study was to compare two different approaches to extubation. Methods: Single-center, retrospective cohort study including infants born at 22 + 0-25 + 6 weeks during 2005-2009 and 2011-2015, before and after implementing guidelines recommending delayed extubation. Primary outcomes were BPD, duration of MV and length of hospital stay. Results: Eighty-eight infants in the early era and 102 infants in the late era were included. Infants in the first period were younger at first extubation attempt, and a higher number of infants were extubated within 24 h, 72 h, and one week after birth. The number of infants re-intubated and postnatal age at re-intubation did not differ between the groups. The incidence of severe BPD was 28% in the early period compared to 48% in the later (p < 0.01). Infants in the late period had longer duration of MV (17 vs 27 days, p < 0.01) but similar length of hospital stay (118 vs 123, p = 0.21). Conclusion: After implementing guidelines recommending delayed extubation, the incidence of severe BPD was higher and the duration of MV was longer. This supports the strategy to attempt extubation early even in extremely preterm infants.
|
|
| 8. |
- Tamez, Karla Gonzalez, et al.
(författare)
-
Neonatal therapeutic hypothermia in a regional swedish cohort : Adherence to guidelines, transport and outcomes
- 2024
-
Ingår i: Early Human Development. - : Elsevier. - 0378-3782 .- 1872-6232. ; 195
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: Swedish guidelines for therapeutic hypothermia (TH) after perinatal asphyxia were established in 2007, following several randomised studies that demonstrated improved outcomes. We assessed the implementation of hypothermia treatment in a mid-Swedish region with a sizeable proportion of outborn infants.METHOD: A population-based TH cohort from 2007 to 2015 was scrutinised for adherence to national guidelines, interhospital transport, including the use of a cooling mattress made of phase change material for thermal management, and outcomes.RESULTS: Of 136 admitted infants, 99 (73 %) were born outside the hospital. Ninety-eight percent fulfilled the criteria for postnatal depression/acidosis, and all patients had moderate-to-severe encephalopathy. Treatment was initiated within 6 h in 85 % of patients; amplitude-integrated electroencephalography/electroencephalography was recorded in 98 %, cranial ultrasound in 78 %, brain magnetic resonance imaging in 79 %, hearing tests in all, and follow-up was performed in 93 %. Although target body temperature was attained later (p < 0.01) in outborn than in inborn infants, at a mean (standard deviations) age of 6.2 (3.2) h vs 4.4 (2.6) h, 40 % of those transported using the cooling mattress were already within the therapeutic temperature range on arrival, and few were excessively cooled. The mortality rate was 23 %, and 38 % of the survivors had neurodevelopmental impairment at a median of 2.5 years.CONCLUSION: The regionalisation of TH, including interhospital transport, was feasible and resulted in outcomes comparable to those of randomised controlled studies.
|
|
| 9. |
- Tataranno, M. L., et al.
(författare)
-
Morphine affects brain activity and volumes in preterms: An observational multi-center study
- 2020
-
Ingår i: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 144
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: We hypothesized that morphine has a depressing effect on early brain activity, assessed using quantitative aEEG/EEG parameter and depressed activity will be associated with brain volumes at term in extremely preterm infants. Study design: 174 preterm infants were enrolled in 3 European tertiary NICUs (mean GA:26 +/- 1wks) and monitored during the first 72 h after birth with continuous 2 channel aEEG. Six epochs of aEEG recordings were selected and minimum amplitude of aEEG (min aEEG), percentage of time amplitude< 5 mu V (% of time < 5 mu V), spontaneous activity transients (SATrate) and interSAT interval (ISI) were calculated. For infants receiving morphine, the cumulative morphine dosage was calculated. In a subgroup of 58 infants, good quality MRI at term equivalent age (TEA) and the cumulative morphine dose until TEA were available. The effects of morphine administration and cumulative dose on aEEG/EEG measures and on brain volumes were investigated. Results: Morphine administration had a significant effect on all quantitative aEEG/EEG measures, causing depression of early brain activity [longer ISI (beta 2.900), reduced SAT rate (beta -1.386), decreased min aEEG (beta -0.782), and increased % of time < 5 mu V (beta 14.802)] in all epochs. A significant effect of GA and postnatal age on aEEG/EEG measures was observed. Cumulative morphine dose until TEA had a significant negative effect on total brain volume (TBV) (beta -8.066) and cerebellar volume (beta -1.080). Conclusions: Administration of sedative drugs should be considered when interpreting aEEG/EEG together with the negative dose dependent morphine impact on brain development.
|
|
| 10. |
|
|
