Neurodevelopmental outcomes after preterm birth

Colvin, Michael A.; McGuire, William; Fowlie, Peter W

doi:10.1136/bmj.329.7479.1390

Cited by 97 publications

(75 citation statements)

References 7 publications

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“…1,4,5 Os recém-nascidos (RN) sobreviventes apresentam risco de sequelas do neurodesenvolvimento, incluindo paralisia cerebral, défice cognitivo, visual e auditivo. [1][2][3][6][7][8][9][10][11][12][13][14][15][16] Para além da idade gestacional (IG) e do peso ao nascimento (PN), os fatores que mais se associam a sequelas no neurodesenvolvimento são a lesão cerebral major, 1,2,12-26 como a hemorragia intra-periventricular de grau igual a três, a leucomalácia periventricular quística, a displasia broncopulmonar, [22][23][24][25] a retinopatia da prematuridade [22][23][24][25] e a sépsis. 16,22,24,[27][28][29][30] Em alguns estudos foi referida a influência do género, estando o masculino associado a pior prognóstico.…”

Section: Introductionunclassified

Neurodesenvolvimento em Crianças Nascidas Pré-Termo de Muito Baixo Peso: Fatores de Risco Ambientais e Biológicos

Resende¹,

Martins²,

Faria³

et al. 2017

Acta Pediátrica Port

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Introdução: Pretendeu-se avaliar o neurodesenvolvimento em recém-nascidos pré-termo de muito baixo peso aos 24-30 meses de idade e correlacioná-lo com fatores de risco biológicos e ambientais. Métodos: Estudo observacional, retrospetivo de uma coorte de crianças nascidas entre janeiro de 2005 e dezembro de 2013, com idade gestacional inferior a 32 semanas e/ou peso de nascimento inferior a 1500 g numa maternidade de apoio perinatal diferenciado. Avaliou-se o neurodesenvolvimento aos 24-30 meses através da schedule of growing skills scales II. Considerou--se como existência de sequelas moderadas / graves a presença de paralisia cerebral, quociente de desenvolvimento global inferior a 70, cegueira ou surdez neurossensorial com necessidade de prótese auditiva. Analisaram-se, por regressão logística, os fatores de risco biológicos e ambientais associados significativamente à ocorrência de défice moderado / grave. Resultados: As 551 crianças estudadas apresentavam um peso de nascimento médio de 1222 ± 320 g e idade gestacional média de 29,4 ± 2,3 semanas. Ocorreram 46/551 óbitos (8%). Obteve-se informação do neurodesenvolvimento em 439/505 (87%) crianças. Apresentaram sequelas no neurodesenvolvimento 46/439 (10%): quociente de desenvolvimento global inferior a 70, 29/439 (7%), paralisia cerebral 26/439 (6%), surdez com necessidade de prótese auditiva 8/439 (2%) e um (0,2%) caso de cegueira. No modelo de regressão logística as variáveis que se associaram de modo significativo a sequelas moderadas / graves foram a leucomalácia periventricular quística, baixa escolaridade materna, perímetro craniano inferior ao percentil 3 aos 24-30 meses, malformações congénitas, crianças inseridas em família não convencional e sépsis tardia. Discussão: Fatores biológicos e ambientais são determinantes no neurodesenvolvimento, pelo que devem ser acionadas atempadamente medidas de intervenção nas crianças mais vulneráveis. Palavras-chave:Criança; Distúrbios do Neurodesenvolvimento; Fatores de Risco; Fatores Socioeconómicos; Recém-Nascido de Muito Baixo Peso; Recém-Nascido Prematuro Abstract Introduction: We aimed to assess neurodevelopment outcome in very low birth weight preterm newborns at 24-30 months of age and to correlate it with biological and environmental risk factors. Methods: In an observational case-cohort study of infants born between January 2005 and December 2013, with gestational age less than 32 weeks and/or birth weight less than 1500 g in a maternity hospital with specialised perinatal support, we assessed neurodevelopmental outcome at 24-30 months by means of the Schedule of Growing Skills II. Moderate/severe deficit was considered to be present if the child had cerebral palsy, overall Developmental Quotient less than 70, blindness or profound sensorineural deafness requiring hearing aids. Biological and environmental risk factors independently associated with the presence of moderate/severe deficit were analysed by logistic regression. Results: The 551 children studied had a mean birth weight and gestational age of ...

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Section: Introductionunclassified

Neurodesenvolvimento em Crianças Nascidas Pré-Termo de Muito Baixo Peso: Fatores de Risco Ambientais e Biológicos

Resende¹,

Martins²,

Faria³

et al. 2017

Acta Pediátrica Port

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“…1 Children who are born preterm are more likely to experience early death, respiratory illnesses, neurodevelopmental disorders, lower cognitive abilities, and even increased behavioural problems. [2][3][4][5] In addition to possible physical and psychological damage to a child's health, preterm birth may also increase the economic burdens of the families in terms of increased healthcare costs and/or educational expenditure. 6 There are three types of preterm birth: spontaneous preterm birth; medically indicated preterm birth, as well as maternal elective preterm birth; and caesarean preterm birth.…”

Section: Introductionmentioning

confidence: 99%

Maternal exposure to heatwave and preterm birth inBrisbane,Australia

Wang

Williams

Lee

et al. 2013

BJOG

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Objective To quantify the short-term effects of maternal exposure to heatwave on preterm birth.Design An ecological study.Setting A population-based study in Brisbane, Australia.Population All pregnant women who had a spontaneous singleton live birth in Brisbane between November and March in 2000-2010 were studied.Methods Daily data on pregnancy outcomes, meteorological factors, and ambient air pollutants were obtained. The Cox proportional hazards regression model with time-dependent variables was used to examine the short-term impact of heatwave on preterm birth. A series of cut-off temperatures and durations were used to define heatwave. Multivariable analyses were also performed to adjust for socio-economic factors, demographic factors, meteorological factors, and ambient air pollutants.Main outcome measure Spontaneous preterm births.Results The adjusted hazard ratios (HRs) ranged from 1.13 (95% CI 1.03-1.24) to 2.00 (95% CI 1.37-2.91) by using different heatwave definitions, after controlling for demographic, socio-economic, and meteorological factors, and air pollutants.Conclusions Heatwave was significantly associated with preterm birth: the associations were robust to the definitions of heatwave. The threshold temperatures, instead of duration, could be more likely to influence the evaluation of birth-related heatwaves. The findings of this study may have significant public health implications as climate change progresses.

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“…The major clinical outcomes that are important to neonates and their families are survival and normal long-term neurodevelopment. 55 This is in distinction to the trajectory of some policy suggestions where the primary concern of the paediatric health care provider is seen to be treating the stress or pain experience. 56 Such an approach neglects the functional purposes of physiological stress responses to noxious stimuli, including, for instance, modulation of inflammation.…”

Section: Clinical and Policy Implications: Surgerymentioning

confidence: 99%

Fetal Pain: Do We Know Enough to Do the Right Thing?

Derbyshire

2008

Reproductive Health Matters

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Neurodevelopmental outcomes after preterm birth

Cited by 97 publications

References 7 publications

Neurodesenvolvimento em Crianças Nascidas Pré-Termo de Muito Baixo Peso: Fatores de Risco Ambientais e Biológicos

Neurodesenvolvimento em Crianças Nascidas Pré-Termo de Muito Baixo Peso: Fatores de Risco Ambientais e Biológicos

Maternal exposure to heatwave and preterm birth inBrisbane,Australia

Fetal Pain: Do We Know Enough to Do the Right Thing?

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