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Preterm AND Quality Of Life

Clément Chollat, Loic Sentilhes, Stéphane Marret
Cerebral palsy (CP) remains the most significant neurological disorder associated with preterm birth. It disrupts quality of life and places huge cost burdens on society. Antenatal magnesium sulphate administration to females before 32 weeks' gestation has proven to be an effective intervention to reduce the rate of CP. In models of hypoxia, hypoxia-ischemia, inflammation, and excitotoxicity in various animal species, magnesium sulphate preconditioning decreased the resulting lesion sizes and inflammatory cytokine levels, prevented cell death, and improved long-term cognitive and motor behaviours...
October 7, 2018: Developmental Medicine and Child Neurology
Gehan Roberts
No abstract text is available yet for this article.
October 3, 2018: Archives of Disease in Childhood
Jacek Przemyslaw Grabowski, Rolf Richter, Hannah Rittmeister, Radoslav Chekerov, Hannah Woopen, Jalid Sehouli
BACKGROUND/AIM: Chemotherapy-associated toxicity is one of the limiting factors regarding treatment efficacy, patient outcome and quality of life in this collective. Underweight or obese patients represent a major group in which the therapy seems to be more challenging. The aim of this analysis was to evaluate the impact of BMI on the toxicity in patients undergoing chemotherapy. PATIENTS AND METHODS: The data of three prospective phase II/III studies ('Tower', 'Topotecan phase III' and 'Hector') of the North-Eastern German Society of Gynecological Oncology including 1,213 patients with recurrent ovarian cancer were retrospectively analyzed...
October 2018: Anticancer Research
Stavros Petrou
Despite an increasing body of knowledge on the adverse clinical sequelae associated with late preterm birth and early term birth, little is known about their economic consequences or the cost-effectiveness of interventions aimed at their prevention or alleviation of their effects. This review assesses the health economic evidence surrounding late preterm and early term birth. Evidence is gathered on hospital resource use associated with late preterm and early term birth, economic costs associated with late preterm and early term birth, and economic evaluations of prevention and treatment strategies...
September 26, 2018: Seminars in Fetal & Neonatal Medicine
Tiffany L Harriman, Brigit Carter, Robin B Dail, Katherine E Stowell
BACKGROUND: Preterm infants are a vulnerable patient population, especially during the first hours of life. Hypothermia, hypoglycemia, and early-onset sepsis are common problems related to prematurity. Implementation of a Golden Hour protocol has been shown to improve outcomes for preterm infants. PURPOSE: To evaluate the effectiveness of a Golden Hour protocol for infants born at less than 32 weeks' gestation on improving the admission process in a military care facility...
September 12, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Amna Widad A Nasuf, Shalini Ojha, Jon Dorling
BACKGROUND: Placing a small volume of colostrum directly onto the buccal mucosa of preterm infants during the early neonatal period may provide immunological and growth factors that stimulate the immune system and enhance intestinal growth. These benefits could potentially reduce the risk of infection and necrotising enterocolitis (NEC) and improve survival and long-term outcome. OBJECTIVES: To determine if early (within the first 48 hours of life) oropharyngeal administration of mother's own fresh or frozen/thawed colostrum can reduce rates of NEC, late-onset invasive infection, and/or mortality in preterm infants compared with controls...
September 7, 2018: Cochrane Database of Systematic Reviews
Philip S Nawrocki, Matthew Levy, Nelson Tang, Shawn Trautman, Asa Margolis
INTRODUCTION: Interfacility transport of the pregnant patient poses a challenge for prehospital providers as it is an infrequent but potentially high acuity encounter. Knowledge of clinically significant events (CSEs) that occur during these transports is important both to optimize patient safety and also to help enhance crew training and preparedness. This study evaluated a critical care transport program's 5-year longitudinal experience transporting pregnant patients by ground and air, and described CSEs that occurred during the out-of-hospital phase of care...
September 25, 2018: Prehospital Emergency Care
Moran Gigi, Jonathan Roth, Rina Eshel, Shlomi Constantini, Haim Bassan
AIM: To determine the health-related quality of life (HRQoL) of children born preterm (gestational age <32wks) after post-haemorrhagic hydrocephalus requiring shunt (PHH-S), and to examine the impact of perinatal and neurological morbidity on their QoL. METHOD: Forty infants (18 females, 22 males; aged 2y 2mo-8y 4.5mo) born preterm with PHH-S were matched for gestational age, birthweight, and sex with infants born preterm with normal cranial ultrasonography. Pediatric QoL Inventory parent-proxy report was administered at a mean age of 5 years 8 months...
September 6, 2018: Developmental Medicine and Child Neurology
Anne Synnes, Matthew Hicks
Despite improved survival of preterm infants, there has not been an equivalent improvement in long-term neurodevelopmental outcomes. Adverse neurodevelopmental outcome rates and severity are inversely related to the degree of prematurity, but only 1.6% are born very preterm and the motor, cognitive, behavioral, and psychiatric disabilities in the large moderate and late preterm population have a greater impact. The disability-free preterm adult has a lower educational achievement and income but similar health-related quality of life to term controls...
September 2018: Clinics in Perinatology
Ana Carolina Bueno Silva, Leni Marcia Anchieta, Marianna Fischer de Paula Lopes, Roberta Maia de Castro Romanelli
BACKGROUND: Technologies and life support management have enhanced the survival of preterm infants. The immune system of newborns is immature, which contributes to the occurrence of healthcare-associated infections. The overlap of several conditions with neonatal sepsis and the difficulty of diagnosis and laboratory confirmation during this period result in a tendency to over-treat neonatal sepsis. The use of antimicrobial agents is a risk factor for multidrug-resistant bacterial infections...
August 18, 2018: Brazilian Journal of Infectious Diseases
Alexander Procaskey, Heather White, Tregony Simoneau, Nadav Traeger, Thomas Lahiri, Elie Abu Jawdeh, Ted Kremer, Catherine Sheils, Kathleen Meyer, Ted Rosenkrantz, Krishnan Sankaran, Tyler Hartman, Henry Feldman, Lawrence Rhein
Improved survival among preterm infants has led to an increase in diagnosis of chronic lung disease and infants discharged home from the NICU on supplemental oxygen. Despite this increased prevalence, no clearly defined guidelines for the management of home oxygen therapy (HOT) exist. This lack of consensus leads to significant variability in the duration of home oxygen therapy and a general paucity of evidence-based practice. Our team has identified recorded home oxygen therapy (RHO) as a potential new resource to guide clinical decision making in the outpatient pulmonology clinic...
August 11, 2018: Contemporary Clinical Trials
Clement L Ren, Rui Feng, Stephanie D Davis, Eric Eichenwald, Alan Jobe, Paul E Moore, Howard B Panitch, Jack K Sharp, Jeff Kisling, Charles Clem, James S Kemp
RATIONALE: The relationship between respiratory function at hospital discharge and the severity of later respiratory disease in extremely low gestational age neonates is not well defined. OBJECTIVES: To test the hypothesis that tidal breathing measurements near the time of hospital discharge differ between extremely premature infants with BPD or respiratory disease in the first year of life compared to those without these conditions. METHODS: Study subjects were part of the Prematurity and Respiratory Outcomes Program (PROP) study, a longitudinal cohort study of infants born <29 gestational weeks followed from birth to 1 year of age...
August 8, 2018: Annals of the American Thoracic Society
Jacqueline T Bangma, Evan Kwiatkowski, Matthew Psioda, Hudson P Santos, Stephen R Hooper, Laurie Douglass, Robert M Joseph, Jean A Frazier, Karl C K Kuban, Thomas M O'Shea, Rebecca C Fry
OBJECTIVE: To assess the development of a Positive Child Health Index (PCHI) based on 11 adverse outcomes and evaluate the association of PCHI with quality of life (QoL) scores in a preterm cohort. STUDY DESIGN: A total of 889 children enrolled in the Extremely Low Gestational Age Newborn (ELGAN) study in 2002-2004 were followed up at 10 years of age. A parent/caregiver completed questionnaires for child QoL, asthma, visual or hearing impairment, gross motor function impairment, epilepsy, attention deficit/hyperactivity disorder, anxiety, and depression...
August 2, 2018: Journal of Pediatrics
B D Garg, H Balasubramanian, N S Kabra, A Bansal
BACKGROUND: Necrotising enterocolitis (NEC) is one of the most common life-threatening emergencies of the gastrointestinal tract in preterm neonates. The present study aimed to determine the efficacy of oropharyngeal colostrum with respect to reducing NEC in preterm neonates. METHODS: A literature search was conducted for various randomised control trials by searching the Cochrane Central Register of Controlled Trials, PubMed, EMBASE and ongoing clinical trials...
August 2, 2018: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
A Aslam, M Vincer, A Allen, S Imanullah, C M O'Connell
BACKGROUND: Normal saline bolus is commonly used in clinical practice for treating hypotension in very preterm infants during resuscitation at an early age despite the paucity of high quality evidence supporting this practice. OBJECTIVES: To determine the effects of early (<7 days after birth) saline boluses given to very preterm infant (VPI) from 23 to 31 weeks GA. METHOD: This is a population-based cohort analysis of the use of normal saline boluses given to VPI...
2018: Journal of Neonatal-perinatal Medicine
Vibhuti Shah, Kate Hodgson, Mary Seshia, Michael Dunn, Georg M Schmölzer
Objectives: To determine 'Golden Hour' resuscitation and stabilization practices for infants <32 weeks gestational age in Canadian neonatal intensive care units (NICUs). Methods: A survey was distributed to investigators of the Evidence-based Practice for Improving Quality study within the Canadian Neonatal Network in June 2014. The questionnaire was designed to obtain information on antenatal counselling, resuscitation environment, resuscitation and management practices, including respiratory and nutritional practices in the first hour of life...
July 2018: Paediatrics & Child Health
Yang Liu, Wen-Bin Dong
With the increase in the rescue success rate of critically ill preterm infants and extremely preterm infants, the incidence rate of bronchopulmonary dysplasia (BPD) is increasing year by year. BPD has a high mortality rate and high possibility of sequelae, which greatly affects the quality of life of preterm infants and brings a heavy burden to their families, and so the treatment of BPD is of vital importance. At present, no consensus has been reached on the treatment measures for BPD. However, recent studies have shown that early application of caffeine can prevent BPD...
July 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Kobi Best, Fiona Bogossian, Karen New
BACKGROUND: Elevated sound levels and low language exposures of preterm infants (< 37 weeks) cared for in the neonatal unit contribute to poorer growth, cognition, language and motor outcomes. These delays can have lasting effects on childhood development and continue throughout adult life. Whilst recommendations have been established for appropriate sound exposure levels in neonatal units, very little is known about the optimal level of language exposure. OBJECTIVES: To examine the evidence regarding language exposure, both measured (observational) and prescribed (interventional), in preterm infants (< 37 weeks) cared for in neonatal units and to identify optimal exposure levels to promote neurodevelopment...
2018: Neonatology
Nada Sindičić Dessardo, Elvira Mustać, Srdjan Banac, Sandro Dessardo
INTRODUCTION: Long-lasting respiratory symptoms have a huge impact on the quality of life in prematurely born children. The aim was to investigate paths of assumed causality leading from foetal inflammatory response syndrome (FIRS) to asthma symptoms in preterms. METHODS: Demographic, antenatal, delivery and outcome data were collected from 262 infants with less than 32 completed weeks of gestational age over a 10-year period in a prospective cohort study. The presence of symptoms of asthma beyond the age of 5 years was the primary outcome measure...
August 24, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Valeria Garcia-Flores, Roberto Romero, Derek Miller, Yi Xu, Bogdan Done, Chharitha Veerapaneni, Yaozhu Leng, Marcia Arenas-Hernandez, Nabila Khan, Bogdan Panaitescu, Sonia S Hassan, Luis Marat Alvarez-Salas, Nardhy Gomez-Lopez
Preterm birth is the leading cause of neonatal morbidity and mortality worldwide. Inflammation is causally linked to preterm birth; therefore, finding an intervention that dampens maternal and fetal inflammatory responses may provide a new strategy to prevent adverse pregnancy and neonatal outcomes. Using animal models of systemic maternal inflammation [intraperitoneal injection of lipopolysaccharide (LPS)] and fetal inflammation (intra-amniotic administration of LPS), we found that (1) systemic inflammation induced adverse pregnancy and neonatal outcomes by causing a severe maternal cytokine storm and a mild fetal cytokine response; (2) fetal inflammation induced adverse pregnancy and neonatal outcomes by causing a mild maternal cytokine response and a severe fetal cytokine storm; (3) exendin-4 (Ex4) treatment of dams with systemic inflammation or fetal inflammation improved adverse pregnancy outcomes by modestly reducing the rate of preterm birth; (4) Ex4 treatment of dams with systemic, but not local, inflammation considerably improved neonatal outcomes, and such neonates continued to thrive; (5) systemic inflammation facilitated the diffusion of Ex4 through the uterus and the maternal-fetal interface; (6) neonates born to Ex4-treated dams with systemic inflammation displayed a similar cytokine profile to healthy control neonates; and (7) treatment with Ex4 had immunomodulatory effects by inducing an M2 macrophage polarization and increasing anti-inflammatory neutrophils, as well as suppressing the expansion of CD8+ regulatory T cells, in neonates born to dams with systemic inflammation...
2018: Frontiers in Immunology
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