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- Valentin, Lil, et al.
(author)
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Fetal movement in the third trimester of normal pregnancy
- 1986
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In: Early Human Development. - : Elsevier BV. - 1872-6232 .- 0378-3782. ; 14:3-4, s. 295-306
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Journal article (peer-reviewed)abstract
- Changes in fetal motor activity may reflect changes in central nervous function and in the health of the fetus. Recording of fetal movement (FM) has therefore been suggested as a method of assessing fetal well-being. To establish the normal range of FMs in the third trimester of pregnancy, FMs were studied cross-sectionally in 180 and longitudinally in 6 healthy women with normal pregnancies. FMs were recorded simultaneously by the mother and by a FM detector using four piezo-electric crystals attached to the maternal abdomen. The recordings lasted for 45 min (cross-sectional study) or 30 min (longitudinal study). The median numbers of FMs recorded during 45 min by the FM detector and by the mother were 85 (2.5th percentile, 14; 97.5th percentile, 232) and 41 (2.5th percentile, 10; 97.5th percentile, 135), respectively. The median 45-min incidences of FMs recorded by the FM detector and by the mother were 8.1% (2.5th percentile, 1.3; 97.5th percentile, 30.2) and 3.7% (2.5th percentile, 0.9; 97.5th percentile, 15.6), respectively. Neither the number nor the incidence of FMs changed appreciably as gestational age advanced. The interindividual variance in the number and incidence of FMs was two to three times greater than the intra-individual variance (longitudinal study). The large variation in the quantity of FMs recorded during 30 and 45 min limits the value of using quantitative FM recording for antepartum fetal monitoring. Individualized normal limits of the quantity of FMs might be preferable to general limits.
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2. |
- Eriksson, Mats, 1959-, et al.
(author)
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Oral glucose and venepuncture reduce blood sampling pain in newborns
- 1999
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In: Early Human Development. - 0378-3782 .- 1872-6232. ; 55:3, s. 211-218
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Journal article (peer-reviewed)abstract
- The objectives of this study were to measure pain symptoms in healthy fullterm newborns undergoing routine blood sampling with different methods. The 120 study subjects were randomly allocated to one of four groups with 30 babies in each, namely venepuncture or heel stick, with or without oral glucose administration. Pain was assessed from the duration of crying within the first 3 min, the Premature Infant Pain Profile (PIPP) and changes in heart rate. When the babies received 1 ml 30% glucose prior to skin puncture there was no significant difference between the heel stick and venepuncture group either in mean crying time (12.9 and 11.6 s, respectively) or in PIPP score (3.9 and 3.3). When no glucose was given crying time was 57.3 s in the heel stick group and 26.8 s in the venepuncture group (P=0.0041) and the mean PIPP scores were 8.4 and 6.0, respectively (P=0.0458). This study suggests that if oral glucose is given prior to skin puncture the choice of blood sampling method has no impact on the pain symptoms.
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4. |
- Hermansson, Liselotte, 1954-, et al.
(author)
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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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In: Early Human Development. - 0378-3782 .- 1872-6232. ; 63:2, s. 131-144
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Journal article (peer-reviewed)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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21. |
- Sommerfelt, K, et al.
(author)
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Behavior in term, small for gestational age preschoolers
- 2001
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In: Early Human Development. - 0378-3782 .- 1872-6232. ; 65:2, s. 107-121
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Journal article (peer-reviewed)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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24. |
- Aaltonen, Minna, et al.
(author)
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Inhaled nitric oxide treatment inhibits neuronal injury after meconium aspiration in piglets
- 2007
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In: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 83:2, s. 77-85
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Journal article (peer-reviewed)abstract
- Background: Meconium aspiration-induced hypertensive lung injury is frequently associated with neuronal damage. Inhaled nitric oxide (iNO) is widely used in the treatment of pulmonary hypertension, but its effects on the brain are poorly known. Aims: The aim of this study was to determine the effects of iNO treatment on the neuronal tissue after meconium aspiration. Study design: 71 anesthetized, catheterized and ventilated newborn piglets were studied for 6 h. Thirty-five piglets were instilled with a bolus of human meconium intratracheally and 36 piglets with saline instillation served as controls. Nineteen meconium piglets and 17 control piglets were continuously treated with 20 ppm of iNO, started at 30 min after the insult. The extent of neuronal injury was analysed histologically, and the levels of brain tissue lipid peroxidation products, reduced glutathione (GSH), myeloperoxidase activity and oxidized DNA were analysed as indicators of oxidative stress. Results: iNO treatment diminished the pulmonary hypertensive response caused by meconium aspiration, but did not change systemic or carotid hemodynamics. NO administration was associated with reduced neuronal injury and diminished amount of oxidized DNA in the hippocampus of the meconium piglets. Further, iNO treatment was associated with decreased level of GSH in the cortex, but no change in lipid peroxidation production or myeloperoxidase activity was detected in any of the studied brain areas. Conclusions: Our results suggest that iNO treatment may inhibit DNA oxidation and neuronal injury in the hippocampus, associated with newborn meconium aspiration.
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26. |
- Andersson, Yvonne, et al.
(author)
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Lactoferrin is responsible for the fungistatic effect of human milk.
- 2000
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In: Early Human Development. - 0378-3782 .- 1872-6232. ; 59:2, s. 95-105
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Journal article (peer-reviewed)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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29. |
- Bystrova, K., et al.
(author)
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The effect of Russian Maternity Home routines on breastfeeding and neonatal weight loss with special reference to swaddling
- 2007
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In: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 83:1, s. 29-39
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Journal article (peer-reviewed)abstract
- Background: Few investigations have considered evaluating the effects of certain combinations of ward routines like swaddling of the baby and separation of mother and baby on infant variables such as neonatal weight toss. Aims: To study the effect of different ward routines in respect to proximity to mother and type of infant apparel, on breastfeeding parameters (amount of ingested milk, volume of supplements, number of breastfeeds, total duration of breastfeeding time) day 4 after birth as well as recovery from neonatal weight loss and infant's weight on day 5. Study design and subjects: In a randomized trial with factorial design four treatment groups including 176 mother-infant dyads were studied 25-120 min after birth. Randomized treatments focused on care routines administered to the infants after delivery and later in the maternity ward as well as to the type of clothing the infants received. Group 1 infants were placed skin-to-skin with their mothers after delivery, and had rooming-in while in the maternity ward. Group 2 infants were dressed and placed in their mothers' arms after delivery, and roomed-in with mothers in the maternity ward. Group 3 infants were kept in the nursery both after birth and while their mothers were in the maternity ward. Group 4 infants were kept in the nursery after birth, but roomed-in with their mothers in the maternity ward. Equal numbers of infants were either swaddled or clothed in baby attire. Breastfeeding parameters were documented during day 4 after birth. Infant's weight was measured daily. Results: Babies who were kept in the nursery received significantly more formula and significantly less breast-milk, than did babies who roomed-in with their mothers. Swaddling did not influence the breastfeeding parameters measured. However, swaddled babies who had experienced a 2-h separation period after birth and then were reunited with their mothers tended to have a delayed recovery of weight loss compared to those infants who were exposed to the same treatment but dressed in clothes. Furthermore, swaddled babies who were kept in the nursery and received breast-milk supplements had a significantly delayed recovery of weight loss after birth when compared to those infants ingesting only breast-milk. On day 5, regression analyses of predicted weight gain in the exclusively breastfed infants indicated a significant increase per 100 ml breast-milk (59 g), compared to the predicted weight gain on day 5 per 100 ml supplements in the swaddled babies (14 g) (P=0.001). Conclusion: Supplements given to the infants in the nursery had a negative influence on the amount of milk ingested. In addition, supplement feeding or a short separation after birth when combined with swaddling was shown to have a negative consequence to infant weight gain.
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30. |
- Cheema, Riffat, et al.
(author)
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Signs of fetal brain sparing are not related to umbilical cord blood gases at birth.
- 2009
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In: Early Human Development. - : Elsevier BV. - 1872-6232 .- 0378-3782. ; 85, s. 467-470
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Journal article (peer-reviewed)abstract
- BACKGROUND: Fetal chronic hypoxia leads to centralization of circulation in order to spare the vital organs brain, adrenals and the heart. This can be documented by Doppler ultrasound. Increased blood velocity in the fetal middle cerebral artery (MCA) is an acknowledged sign of centralization of circulation in chronic hypoxia, and is called brain sparing. AIM: Our aim was to assess the relationship between signs of brain sparing in the MCA and umbilical cord blood gases at birth. STUDY DESIGN: A prospective study. SUBJECTS: Singleton 57 high-risk pregnancies (outcome was compared with 21 normal pregnancies). METHODS: MCA Doppler was performed within 24 h of elective caesarean section in high-risk pregnancies. Umbilical cord blood gases were analysed at birth. MAIN OUTCOME MEASURES: Cord blood gases were related to signs of centralization of fetal circulation in the MCA. RESULTS: No correlation between signs of brain sparing in the MCA and cord blood gases. Apgar score at 5'<7 was seen in three newborns, but only one of these had antenatal signs of brain sparing. Newborns with antenatal brain sparing were admitted more often (p<0.04) and had a longer duration of stay in NICU (p<0.03) compared to newborns without brain sparing. CONCLUSION: Decreased pulsatility index in MCA is an acknowledged sign of fetal centralization of circulation during chronic hypoxia. However, signs of brain sparing are not related to cord blood gases at birth, which might suggest that redistribution of fetal circulation can maintain normal blood gases for a long time during chronic hypoxia.
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31. |
- Dykes, Fiona, et al.
(author)
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Encouraging breastfeeding : A relational perspective
- 2010
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In: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 86:11, s. 733-736
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Journal article (peer-reviewed)abstract
- Despite the WHO recommendations that babies should be breastfed exclusively for six months and thereafter for up to two years and beyond this pattern of feeding is far from the global norm. Although breastfeeding is triggered through biological mechanisms which have not changed with time, the perception of breastfeeding as a phenomenon is variable, as it not only reflects cultural values of motherhood but is also negotiable from the perspective of the individual. This paper argues that relationships are central to encouraging breastfeeding at an organisational, family and staff-parent level. This shifts our conceptualisations away from the primary focus of breastfeeding as nutrition which, in turn, removes the notion of breastfeeding as a productive process, prone to problems and failure.
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33. |
- Fu, Jing, et al.
(author)
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Intracerebral regional distribution of blood flow in response to uterine contractions in growth-restricted human fetuses.
- 2007
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In: Early Human Development. - : Elsevier BV. - 1872-6232 .- 0378-3782. ; 83:9, s. 607-612
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Journal article (peer-reviewed)abstract
- Objective: To explore middle cerebral artery (MCA) and anterior cerebral artery (ACA) blood flow responses to superimposed acute hypoxemia in growth -restricted fetuses with and without established brain-sparing flow during basal conditions. Material and methods: 47 term fetuses suspected of growth restriction were exposed to an oxytocin challenge test with simultaneous cardiotocography and Doppler velocimetry in the umbilical artery, MCA and ACA. The MCA-to-ACA pulsatility index (PI) ratio was calculated during basal conditions, contractions and relaxations. Basal brain-sparing flow was defined as an MCA-to-umbilical artery PI ratio of <1.08, de novo brain-sparing flow in the MCA as an MCA PI decrease with I standard deviation during uterine contractions or relaxations compared with basal measurements, and de novo brain-sparing flow in the ACA as an ACA PI decrease with l standard deviation. Non-parametric statistical tests were used with P<0.05 considered significant. Results: MCA and ACA PI were both significantly tower in the brain-sparing flow group (N=8) during basal conditions (P <= 0.01). During the oxytocin challenge test, MCA and ACA PI both decreased in the non-brain -sparing flow group (N=39) (P <= 0.02) but not in the brain -sparing flow group (P >= 0.4). The MCA-to-ACA PI ratio remained unchanged in both groups. de novo brain-sparing flow calculations revealed no preferential flow to any cerebral artery. Conclusion: Cerebral circulatory responses to acute hypoxemia are synchronized in the middle and anterior cerebral arteries without any preferential regional flow distribution.
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34. |
- Fu, Jing, et al.
(author)
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Restrained cerebral hyperperfusion in response to superimposed acute hypoxemia in growth-restricted human fetuses with established brain-sparing blood flow.
- 2006
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In: Early Human Development. - : Elsevier BV. - 1872-6232 .- 0378-3782. ; 82:Dec 1, s. 211-216
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Journal article (peer-reviewed)abstract
- Objective: To investigate the cerebral circulatory response to superimposed acute hypoxemia in growth-restricted fetuses with established brain-sparing flow (BSF) during basal conditions. Material and methods: 76 term fetuses suspected of growth restriction were exposed to Doppler velocimetry in the umbitical artery (UA) and middle cerebral artery (MCA), and in 38-39 cases also in Galen's vein (GV), straight sinus (SS), and transverse sinus (TS), before and during an oxytocin challenge test (OCT), and simultaneous to electronic fetal heart rate monitoring. Nonparametric statistical analyses compared presence/absence of established BSF (MCA-to-UA pulsatility index [PI] ratio < 1.08) with a two-tailed P < 0.05 considered significant. Results: The OCT (positive/negative) was not different in the BSF group (BSFG, N = 16) and the normal flow group (NFG, N=60) (P=0.2). During uterine contractions, the MCA PI decreased in the NFG, but not in the BSFG. De novo GV pulsations and increase of GV maximum flow velocity occurred during contractions in the NFG, but not in the BSFG. Significant SS flow velocity waveform changes were found in neither group and TS flow changes in the BSFG only. Conclusions: Fetuses without established brain-sparing flow during basal conditions responded with both arterial and venous brain-sparing flow during acute hypoxemia, whereas in fetuses with established brain-sparing flow the cerebral circulatory responses were absent or equivocal. Fetuses with established brain-sparing flow may have a limited capacity of further cerebral hyperperfusion during superimposed acute hypoxic stress. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
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35. |
- Germa, Alice, et al.
(author)
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Neonatal factors associated with alteration of palatal morphology in very preterm children : The EPIPAGE cohort study
- 2012
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In: Early Human Development. - : Elsevier. - 0378-3782 .- 1872-6232. ; 88:6, s. 413-420
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Journal article (peer-reviewed)abstract
- Background: Altered palatal morphology has been observed among some preterm children, with possible consequences on chewing, speaking and esthetics, but determinants remain unknown. Aim: To explore the role of neonatal characteristics and neuromotor dysfunction in alteration of palatal morphology at 5 years of age in very preterm children. Study design: Prospective population-based cohort study. Subjects: 1711 children born between 22 and 32 weeks of gestation in 1997 or born between 22 and 26 weeks of gestation in 1998 were included in the study. They all had a medical examination at 5 years of age. Outcome measures: Alteration of palatal morphology. Results: The prevalence of altered palatal morphology was 3.7% in the overall sample, 5.1% among boys and 2.2% among girls (adj OR: 2.52; 95%CI: 1.44–4.42). The risk for altered palatal morphology was higher for lower gestational age (adj OR: 0.85; 95%CI: 0.74–0.97 per week), small-for-gestational age children (adj OR: 2.11; 95%CI: 1.20–3.72) or children intubated for more than 28 days (adj OR: 3.16; 95%CI: 1.11–8.98). Altered palatal morphology was more common in case of cerebral palsy or moderate neuromotor dysfunction assessed at 5 years. Results were basically the same when neuromotor dysfunction was taken into account, except for intubation. Conclusion: Male sex, low gestational age, small-for-gestational age and long intubation have been identified as probable neonatal risk factors for alteration of palatal morphology at 5 years of age in very preterm children. Further studies are needed to confirm these results.
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36. |
- Gradin, Maria, et al.
(author)
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Feeding and oral glucose : additive effects on pain reduction in newborns
- 2004
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In: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 77:1-2, s. 57-65
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Journal article (peer-reviewed)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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37. |
- Griffin, Ian J., et al.
(author)
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Zinc and copper requirements in preterm infants : An examination of the current literature
- 2013
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In: Early Human Development. - : Elsevier. - 0378-3782 .- 1872-6232. ; 89:Supplement 2, s. S29-S34
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Journal article (peer-reviewed)abstract
- Background: Zinc and copper are essential for preterm infants, but recommended requirements from different groups vary widely. Recommended zinc intakes have steadily increased over the years. Although this would be expected to impair copper absorption, recommended copper intakes have not risen in parallel.Objectives: To systematically review the literature on zinc and copper retention in preterm infants; to examine the effect on zinc intake on copper retention; and to estimate the zinc and copper intakes required to meet the levels of zinc and copper retention required for normal growth.Design: Studies reporting zinc and/or copper retention in preterm infants (<36 weeks of gestation) during the first 120 days of life were identified using PubMed. Only studies reporting net retention were included.Results: Fourteen studies on zinc retention reporting data on 45 different groups were identified. Eleven studies (32 groups) were identified reporting copper retention. Zinc retention was significantly higher at higher zinc intakes, and higher in formula-based diets than in human milk based diets. Zinc intakes of between 1.8-2.4 mg/kg/d (from formula based diets) and 23-2.4 mg/kg/d (from human-milk based diets) were required to achieve adequate zinc retention. Copper retention was significantly positively correlated with copper intake and significantly negatively correlated with zinc intake. At the zinc intakes suggested previously (1.8-2.4, 2.3-2.4 mg/kg/d), copper intakes of between 200 and 250 mcg/kg/d are required to ensure adequate copper retention.Conclusions: Our results support the higher zinc intakes recommended in recent guidelines. However, they suggest that recommended copper intakes have not kept pace with increasing zinc intakes, and that preterm infants may need higher copper intakes than currently recommended.
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- Gäddlin, Per-Olof, 1946-, et al.
(author)
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A fifteen-year follow-up of neurological conditions in VLBW children without overt disability: Relation to gender, neonatal risk factors, and end stage MRI findings
- 2008
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In: Early Human Development. - : Elsevier. - 0378-3782 .- 1872-6232. ; 84:5, s. 343-349
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Journal article (peer-reviewed)abstract
- Background: Very low birthweight (VLBW; birth weight ≤ 1500 g) children run a greater risk than controls of developing neurosensory disabilities, but also minor neurological disturbances. Aims: To assess neurological status from the neonatal period up to fifteen years of age in VLBW children without overt neurological disability in relation to gender, neonatal risk factors, and Magnetic Resonance Imaging (MRI) findings of the brain. Study design: A population based follow-up study of VLBW children and their controls. Subjects: Eighty VLBW children without overt disability, in a cohort of 86 surviving VLBW children, were enrolled in a follow-up study at 40 weeks gestational age and at 4, 9, and 15 years of age. 56 VLBW children were examined with cerebral MRI at 15 years of age. Outcome measures: Neurological test scores. MRI findings, principally white matter damage (WMD). Results: VLBW children were inferior in neurological assessments in comparison with controls at 40 weeks gestational age and 4 and 15 years of age. VLBW girls did not differ from their controls at 9 and 15 years. Fourteen of 56 (25%) VLBW children had abnormal MRI findings and 13 were evaluated as mild WMD. Children with WMD did not differ in neurological outcome from those without WMD at any examination. Mechanical ventilation and/or intraventricular haemorrhage (IVH) during the neonatal period were significantly related to less a favourable outcome at follow-up examinations. Conclusion: A cohort of VLBW children without overt neurological disability had a poorer neurological condition up to adolescence in comparison with controls. A quarter of the VLBW children had mild WMD but without relation to the neurological functions. Mechanical ventilation and IVH were related to poorer neurological outcome.
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40. |
- Hagberg, Henrik, 1955, et al.
(author)
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Brain injury in preterm infants--what can the obstetrician do?
- 2005
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In: Early human development. - : Elsevier BV. - 0378-3782. ; 81:3, s. 231-5
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Research review (peer-reviewed)abstract
- Mothers at increased risk of preterm birth often receive glucocorticoids (GC), antibiotics and tocolytics by the obstetrician but the question is whether such interventions affect the risk of brain injury and neurological outcome. We suggest that one single course of antenatal GC is the most important treatment that can be offered to patients at risk of preterm birth at 24-34 weeks of gestation to prevent brain injury. Betamethasone seems advantageous to dexamethasone and repeated courses of GC should probably be avoided. Antibiotics given to patients with preterm premature rupture of membranes reduce neonatal morbidity and decrease the risk of sonographic cerebral abnormalities even though the effect on long-term neurological outcome is uncertain. From the perspective of the immature CNS, there is no evidence for treatment with tocolytics even though it allows transfer of the patient to a tertiary center and increases the likelihood of administration of a complete course of corticosteroids which may affect outcome.
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41. |
- Hellström, Ann, 1959, et al.
(author)
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Screening and novel therapies for retinopathy of prematurity – A review
- 2019
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In: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 138
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Journal article (peer-reviewed)abstract
- © 2019 Elsevier B.V. With current screening for sight threatening retinopathy of prematurity (ROP) <10% of screened infants need treatment. Prediction models based on birth characteristics, postnatal weight gain and other factors have been developed to reduce examinations in low-risk infants. A model based on advanced statistics using data from >7000 infants registered in the Swedish ROP registry is being developed. Based on birth characteristics only, it appears to predict total risk of ROP-treatment as well as models including weight measurements. Treatment risk peaked at 12 weeks of age. Laser therapy is the method of choice for severe ROP. Anti-VEGF therapies are implemented worldwide despite insufficient knowledge of choice of drug, dosage and long term systemic effects. Prevention of ROP may be achieved through oxygen control and provision of the mother's breastmilk. Other interventions such as supplementation with long chain polyunsaturated fatty acids and preservation of fetal haemoglobin are investigated.
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42. |
- Hellström-Westas, Lena, et al.
(author)
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Electroencephalography and brain damage in preterm infants.
- 2005
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In: Early Human Development. - : Elsevier BV. - 1872-6232 .- 0378-3782. ; 81:3, s. 255-261
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Journal article (peer-reviewed)abstract
- Electroencephalography (EEG) is a sensitive method for detection of brain injury in preterm infants. Although the acute and chronic EEG changes are mainly non-specific regarding type of injury, they correlate with later neurological and cognitive function. In infants developing periventricular hemorrhagic or ischemic brain injury, acute EEG findings include depression of background activity and presence of epileptic seizure activity. The chronic EEG changes associated with white matter injury and abnormal neurological development include delayed maturation, and presence of abundant rolandic sharp waves. Suboptimal cognitive development in preterm infants has been associated with changes in various sleep measures in EEG’s recorded at full term. Continuous EEG-monitoring during neonatal intensive care shows that cerebral electrical activity during this vulnerable period can be affected by several extracerebral factors, e.g. cerebral blood flow, acidosis and some commonly used medications. For diagnosis of brain injury in preterm infants with neurophysiological methods, a combination of early continuous EEG monitoring during the initial intensive care period and full EEG, performed at later stages, is probably optimal.
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47. |
- Jelenkovic, Aline, et al.
(author)
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Associations between birth size and later height from infancy through adulthood : An individual based pooled analysis of 28 twin cohorts participating in the CODATwins project
- 2018
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In: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 120, s. 53-60
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Journal article (peer-reviewed)abstract
- Background: There is evidence that birth size is positively associated with height in later life, but it remains unclear whether this is explained by genetic factors or the intrauterine environment. Aim: To analyze the associations of birth weight, length and ponderal index with height from infancy through adulthood within mono- and dizygotic twin pairs, which provides insights into the role of genetic and environmental individual-specific factors. Methods: This study is based on the data from 28 twin cohorts in 17 countries. The pooled data included 41,852 complete twin pairs (55% monozygotic and 45% same-sex dizygotic) with information on birth weight and a total of 112,409 paired height measurements at ages ranging from 1 to 69 years. Birth length was available for 19,881 complete twin pairs, with a total of 72,692 paired height measurements. The association between birth size and later height was analyzed at both the individual and within-pair level by linear regression analyses. Results: Within twin pairs, regression coefficients showed that a 1-kg increase in birth weight and a 1-cm increase in birth length were associated with 1.14–4.25 cm and 0.18–0.90 cm taller height, respectively. The magnitude of the associations was generally greater within dizygotic than within monozygotic twin pairs, and this difference between zygosities was more pronounced for birth length. Conclusion: Both genetic and individual-specific environmental factors play a role in the association between birth size and later height from infancy to adulthood, with a larger role for genetics in the association with birth length than with birth weight.
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48. |
- Jonas, W., et al.
(author)
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Newborn skin temperature two days postpartum during breastfeeding related to different labour ward practices
- 2007
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In: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 83:1, s. 55-62
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Journal article (peer-reviewed)abstract
- Aim: To investigate (1) the skin temperature pattern in newborns two days after birth in connection to breastfeeding and to examine (2) if the administration of epidural analgesia (EDA) and oxytocin (OT) infusion during labour influences this parameter at this point of time. Method: Forty-seven mother-infant pairs were included in the study: nine mothers had received OT stimulation during labour (OT group), 20 mothers had received an EDA and OT during labour (EDA group), while 18 mothers had received neither EDA nor OT stimulation during labour (control group). A skin temperature electrode was attached between the newborn's shoulder blades. The newborn was placed skin-to-skin on the mother's chest and covered with a blanket. The temperature was recorded immediately after the newborn was put on the mother's chest and at 5, 10, 20 and 30 min. Results: The temperature measured when the newborns were put skin-to-skin on their mothers' chest was significantly higher in the infants of the EDA group (35.07 °C) when compared to the control group (34.19 °C, p = 0.025). Skin temperature increased significantly (p = 0.001) during the entire experimental period in the infants belonging to the control group. The same response was observed in infants whose mothers received OT intravenously during labour (p = 0.008). No such rise was observed in infants whose mothers were given an EDA during labour. Conclusion: The results show that the skin temperature in newborns rises when newborns are put skin-to-skin to breastfeed two days postpartum. This effect on temperature may be hampered by medical interventions during labour such as EDA. © 2006 Elsevier Ireland Ltd. All rights reserved.
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49. |
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50. |
- Kleberg, Agneta, et al.
(author)
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Mothers' perception of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) as compared to conventional care.
- 2007
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In: Early Human Development. - : Elsevier BV. - 1872-6232 .- 0378-3782. ; 83:6, s. 403-411
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Journal article (peer-reviewed)abstract
- Background: Family-centred care according to the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) has been reported to positively influence family function. The aim was to examine if NIDCAP affects the views of prematurely born infants' mothers regarding maternal rote, perception of the infant and the neonatal care. Method: Preterm infants with gestational age < 32 weeks were randomly assigned to receive either care based on NIDCAP (n = 12) or conventional neonatal care (n = 13), forming two comparable groups with respect to gestational age, birth weight, female/male ratio, and initial illness severity. A questionnaire was designed to evaluate various aspects of the mothers' attitudes and apprehension of their maternal rote, perception of their infant and the neonatal care. The questionnaire was validated and given to the mothers when the infants reached 36 weeks postmenstrual age (PMA). Results: Ten mothers in each group replied to the questionnaire. The mothers in the NIDCAP-group perceived more closeness to their infants than did the control mothers (p = 0.022) and this feeling demonstrated no significant correlation to the infant's gestational age, weight at birth or severity of illness. Furthermore, the mothers in the NIDCAP-group tended to rate the staff's ability to support them in their role as a mother somewhat higher (p = 0.066), but at the same time they expressed more anxiety than did the control mothers (p = 0.033). Conclusion: Early intervention according to NIDCAP seems to facilitate a feeling of closeness between the mother and her premature infant regardless of the infant's birth weight or health status. The higher level of anxiety in the mothers in the NIDCAP-group, may mirror that the mothers in the NIDCAP-group had already bonded to their infants during the hospital stay.
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