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extremely premature

Margie A Ream, Lenora Lehwald
PURPOSE OF REVIEW: Preterm birth is the leading cause of death worldwide in children < 5 years of age; however, technology and advances in medical knowledge are increasing the survival of children born even at the fringes of viability. With increased survival comes increased risk of long-term neurologic impairments. This paper aims to review recent findings related to changes in brain development associated with prematurity and its impact on neurodevelopmental disabilities. RECENT FINDINGS: Advanced imaging techniques, longitudinal follow-up of individuals born extremely preterm into adulthood and improved understanding of risk factors associated with neurologic impairment contribute to recent discoveries...
June 16, 2018: Current Neurology and Neuroscience Reports
Svetlana V Glinianaia, Judith Rankin, Asma Khalil, Julia Binder, Gareth Waring, Stephen N Sturgiss, Basky Thilaganathan, Therese Hannon
OBJECTIVES: To determine the prevalence of monochorionic monoamniotic (MCMA) twin pregnancies and to describe perinatal outcomes and clinical management of these pregnancies. METHODS: This multicentre cohort study used population-based data on MCMA twin pregnancies from 11 Northern Survey of Twin and Multiple Pregnancy (NorSTAMP) maternity units for the prevalence estimation of MCMA twinning. Pregnancy outcomes at <24 weeks' gestation, antenatal parameters and perinatal outcomes (from ≥24 weeks to the first 28 days of life) were analysed using combined data on pregnancies with confirmed MCMA chorionicity from the NorSTAMP and the Southwest Thames Region of London Obstetric Research Collaborative (STORK) multiple pregnancy cohort for 2000-2013...
June 13, 2018: Ultrasound in Obstetrics & Gynecology
Yume Suzuki, Yumi Kono, Takahiro Hayakawa, Hironori Shimozawa, Miyuki Matano, Yukari Yada
BACKGROUND: Although late-onset circulatory collapse (LCC) is widely recognized in Japan, its etiology and the reason for center variation in its incidence remain unclear. This study's objectives were to identify the perinatal and neonatal factors related to LCC and to estimate the factors related to the center variation in the incidence of LCC. METHODS: Extremely preterm infants born between 2008 and 2012 who were registered in the database of the Neonatal Research Network, Japan were retrospectively analyzed...
2018: PloS One
Miguel A Alejandre Alcazar, Mark Kaschwich, Robert Ertsey, Stefanie Preuss, Carlos Milla, Sana Mujahid, Juliet Masumi, Suleman Khan, Lucia M Mokres, Lu Tian, Jasmine Mohr, Dharmesh V Hirani, Marlene Rabinovitch, Richard D Bland
RATIONALE: Mechanical ventilation with O2 -rich gas (MV-O2 ) inhibits alveologenesis and lung growth. We showed that MV-O2 increases elastase activity and apoptosis in lungs of newborn mice; elastase inhibition by elafin suppressed apoptosis and enabled lung growth. In pilot studies, MV-O2 reduced lung expression of pro-survival factors, pEGFR and Klf4. OBJECTIVES: Determine if apoptosis and lung growth arrest evoked by MV-O2 reflect disrupted pEGFR-Klf4 signaling, which elafin treatment preserves...
June 12, 2018: American Journal of Respiratory Cell and Molecular Biology
Antti Holsti, Fredrik Serenius, Aijaz Farooqi
AIM: More infants born extremely preterm (EPT) are surviving, but major neonatal morbidities are consistently high. This study examined the impact of bronchopulmonary dysplasia (BPD), brain injuries and severe retinopathy of prematurity (ROP) on adolescents who were born EPT. METHODS: We focused on EPT infants born at 23-25 weeks at the Swedish university hospitals in Uppsala and Umeå from January 1992 to December 1998. The poor outcome data covered 140/142 who survived to 36 weeks and the chronic conditions data reported by parents covered 132/134 still alive at 10-15 years...
June 11, 2018: Acta Paediatrica
Susanna Klevebro, Vera Westin, Elisabeth Stoltz Sjöström, Mikael Norman, Magnus Domellöf, Anna-Karin Edstedt Bonamy, Boubou Hallberg
BACKGROUND & AIM: Extremely preterm infants face substantial neonatal morbidity. Nutrition is important to promote optimal growth and organ development in order to reduce late neonatal complications. The aim of this study was to examine the associations of early nutritional intakes on growth and risks of bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) in a high-risk population. METHODS: This population-based cohort study includes infants born before 27 0/7 weeks of gestational age without severe malformations and surviving ≥10 days...
May 29, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Jennifer Shepherd, Kai-Hsiang Hsu, Shahab Noori
Although patent ductus arteriosus is essential in fetal life, interventions to close or minimize the adverse hemodynamic effects associated with the left-to-right shunt are often needed after birth, especially in extremely premature infants. However, there are clinical conditions where maintaining patency of the ductus is essential for survival. In this article we discuss use of prostaglandin E1 in the management of congenital heart defects, pulmonary hypertension and left ventricular failure in early neonatal period...
June 1, 2018: Seminars in Fetal & Neonatal Medicine
André Moraes Freitas, Ricardo Mörschbächer, Mariana R Thorell, Ernani Luis Rhoden
Background and objectives: Advances in neonatal care promoted increased survival rates of preterm infants, with a consequent increase in the number of children affected by retinopathy of prematurity (ROP). This study estimates the incidence of ROP and evaluates potential risk factors associated. Methods: A retrospective cohort study of preterm infants born in a tertiary neonatal intensive care unit was conducted from March 2005 to August 2015. Six hundred and thirty-nine newborns were included based on the following criteria: infants born with less than 32 weeks' gestation or birth weight below 1500 g; or neonates born with 32-37 weeks' gestation or birth weight above 1500 g and any of the following associated: multiple gestation, respiratory distress syndrome, sepsis, blood transfusions or intraventricular hemorrhage...
2018: International Journal of Retina and Vitreous
Antonio De Simone, Vincenzo La Rocca, Alfonso Panella, Valter Bianchi, Francesco Maddaluno, Giuseppe Stabile, Ignacio Garcia Bolao
The Rhythmia ultrahigh-density mapping system with a specific algorithm seems to be helpful in identifying the target area to successfully treat multiple morphologies by catheter ablation in the right ventricular outflow tract RVOT. Interestingly, the acquisition process seemed to be extremely faster than a standard manual point-by-point premature ventricular contraction (PVC) mapping.
June 2018: Clinical Case Reports
Amy B Hair, David J Rechtman, Martin L Lee, Victoria Niklas
OBJECTIVE: Articles previously published by Sullivan et al. and Cristofalo et al. were reanalyzed using the proportion of cow milk-based nutrition received to determine whether that affected clinical outcomes during hospitalization for infants birth weight 500-1250 g. Abrams et al. showed in the same cohort incidences of necrotizing enterocolitis (NEC), NEC requiring surgery and sepsis increased proportionally to the amount of dietary cow milk. METHODS: The data from the two studies conducted under essentially the same protocol were combined yielding a cohort of 260 infants receiving a diet ranging from 0% to 100% cow milk...
June 7, 2018: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
Shini Susan Samuel, Benjamin Jeyanth Ross, Grace Rebekah, Santosh Koshy
Background: Presence of teeth in a neonate is a rare occurrence due to the disturbance in the biological chronology of teeth. Although uncommon, these teeth if present are found to have several clinical implications. Aims: This study aimed to describe the clinical characteristics and the treatment outcome of natal and neonatal teeth from a hospital setting. Materials and Methods: This retrospective study was carried out by reviewing the hospital records of babies with natal or neonatal teeth in a tertiary hospital in Tamil Nadu between January 1, 2012, and December 31, 2014...
April 2018: Contemporary Clinical Dentistry
Lisa M Askie, Brian A Darlow, Neil Finer, Barbara Schmidt, Ben Stenson, William Tarnow-Mordi, Peter G Davis, Waldemar A Carlo, Peter Brocklehurst, Lucy C Davies, Abhik Das, Wade Rich, Marie G Gantz, Robin S Roberts, Robin K Whyte, Lorrie Costantini, Christian Poets, Elizabeth Asztalos, Malcolm Battin, Henry L Halliday, Neil Marlow, Win Tin, Andrew King, Edmund Juszczak, Colin J Morley, Lex W Doyle, Val Gebski, Kylie E Hunter, Robert J Simes
Importance: There are potential benefits and harms of hyperoxemia and hypoxemia for extremely preterm infants receiving more vs less supplemental oxygen. Objective: To compare the effects of different target ranges for oxygen saturation as measured by pulse oximetry (Spo2) on death or major morbidity. Design, Setting, and Participants: Prospectively planned meta-analysis of individual participant data from 5 randomized clinical trials (conducted from 2005-2014) enrolling infants born before 28 weeks' gestation...
June 5, 2018: JAMA: the Journal of the American Medical Association
Astrid M Suchy-Dicey, Clemma J Muller, Tara M Madhyastha, Dean Shibata, Shelley A Cole, Jinying Zhao, W T Longstreth, Dedra Buchwald
Telomeres are repeating regions of DNA that cap chromosomes. They shorten over the mammalian life span, especially in the presence of oxidative stress and inflammation. Telomeres may play a direct role in cell senescence, serving as markers of premature vascular aging. Leukocyte telomere length (LTL) may be associated with premature vascular brain injury and cerebral atrophy. However, reports have been inconsistent, especially among minority populations with a heavy burden of illness related to vascular aging...
June 1, 2018: American Journal of Epidemiology
Elsa Lorthe, Héloïse Torchin, Pierre Delorme, Pierre-Yves Ancel, Laetitia Marchand-Martin, Laurence Foix-L'helias, Valérie Benhammou, Catherine Gire, Claude D'Ercole, Norbert Winer, Loïc Sentilhes, Damien Subtil, François Goffinet, Gilles Kayem
BACKGROUND: Most clinical guidelines state that with early preterm premature rupture of membranes, obstetric and pediatric teams must share a realistic and individualized appraisal of neonatal outcomes with parents and consider their wishes for all decisions. However, we currently lack reliable and relevant data, according to gestational age at rupture of membranes, to adequately counsel parents during pregnancy and to reflect on our policies of care at these extreme gestational ages...
May 28, 2018: American Journal of Obstetrics and Gynecology
Nahed O ElHassan, Shasha Bai, Neal Gibson, Greg Holland, James M Robbins, Jeffrey R Kaiser
BACKGROUND: The relative influence of prematurity vs. maternal social factors (socioeconomic status and education level) on academic performance has rarely been examined. OBJECTIVE: To examine the impact of prematurity and maternal social factors on academic performance from 3rd through 8th grade. METHODS: We conducted a retrospective cohort study of infants born in 1998 at the University of Arkansas for Medical Sciences. The study sample included 58 extremely low gestational age newborns (ELGANs, 23‒<28 weeks), 171 preterm (≥28‒<34 weeks), 228 late preterm (≥34‒<37 weeks), and 967 term ((≥37‒<42 weeks) infants...
2018: PloS One
Giovanni Forzieri, Alessandro Cescatti, Filipe Batista E Silva, Luc Feyen
BACKGROUND: The observed increase in the effects on human beings of weather-related disasters has been largely attributed to the rise in population exposed, with a possible influence of global warming. Yet, future risks of weather-related hazards on human lives in view of climate and demographic changes have not been comprehensively investigated. METHODS: We assessed the risk of weather-related hazards to the European population in terms of annual numbers of deaths in 30 year intervals relative to the reference period (1981-2010) up to the year 2100 (2011-40, 2041-70, and 2071-100) by combining disaster records with high-resolution hazard and demographic projections in a prognostic modelling framework...
August 2017: Lancet. Planetary Health
Janet B Sharpe, Mark W Davies
AIM: The risk of mortality and morbidity is increased in outborn, extremely premature infants. We aim to determine whether earlier arrival of the retrieval team after the birth of infants less than 29 weeks gestation improves short-term mortality and morbidity. METHODS: This is a retrospective analysis of a cohort of infants less than 29 weeks gestation who were retrieved to the Royal Brisbane and Women's Hospital (RBWH) over a 5-year period. Demographic information regarding the infant and mother, retrieval team arrival time and outcome data was collected...
May 31, 2018: Journal of Paediatrics and Child Health
Michelle C Starr, Joseph T Flynn
Neonatal hypertension is increasingly recognized as dramatic improvements in neonatal intensive care, advancements in our understanding of neonatal physiology, and implementation of new therapies have led to improved survival of premature infants. A variety of factors appear to be important in determining blood pressure in neonates, including gestational age, birth weight, and postmenstrual age. Normative data on neonatal blood pressure values remain limited. The cause of hypertension in an affected neonate is often identified with careful diagnostic evaluation, with the most common causes being umbilical catheter-associated thrombosis, renal parenchymal disease, and chronic lung disease...
May 28, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Xiangrong Zheng, Weishe Zhang, Chan Lu, Dan Norbäck, Qihong Deng
It is well known that exposure to thermal stress during pregnancy can lead to an increased incidence of premature births. However, there is little known regarding window(s) of susceptibility during the course of a pregnancy. We attempted to identify possible windows of susceptibility in a cohort study of 3604 children in Changsha with a hot-summer and cold winter climatic characteristics. We examined the association between PTB and ambient temperature during different timing windows of pregnancy: conception month, three trimesters, birth month and entire pregnancy...
May 2018: Journal of Thermal Biology
Vithiya Ratnasamy, Suganthan Navaneethakrishnan, Nirmala Dushyanthi Sirisena, Nana-Maria Grüning, Oliver Brandau, Kumanan Thirunavukarasu, Casey L Dagnall, Lisa J McReynolds, Sharon A Savage, Vajira H W Dissanayake
BACKGROUND: Dyskeratosis congenita (DC) is a rare genetic disorder of bone marrow failure inherited in an X-linked, autosomal dominant or autosomal recessive pattern. It has a wide array of clinical features and patients may be cared for by many medical sub specialties. The typical clinical features consist of lacy reticular skin pigmentation, nail dystrophy and oral leukoplakia. As the disease advances, patients may develop progressive bone marrow failure, pulmonary fibrosis, oesophageal stenosis, urethral stenosis, liver cirrhosis as well as haematological and solid malignancies...
May 25, 2018: BMC Medical Genetics
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