Postnatal systemic inflammation and neuro‐ophthalmologic dysfunctions in extremely low gestational age children

Abstract

Aim Compared to infants born at term, children born very preterm are at increased risk of visual dysfunctions, and neonatal systemic inflammation. Here we explore if these two propensities are related. Methods As part of the ELGAN study, the concentrations of 16 mediators of inflammation were measured in blood obtained on postnatal days 1, 7, 14, 21 and 28 from 1062 children born before the 28th week of gestation. Presence of visual field deficit, strabismus, and/or impaired visual fixation was recorded at age two. The concentrations of each protein were divided into quartiles within gestational week categories. We calculated odds ratios with 99% confidence intervals for having each disorder comparing children with concentration in the top quartile of each protein to children whose concentration was in the lower quartiles on the corresponding day. Analyses were adjusted for gestational age and birth weight Z-score. Results Only one of 90 assessments (16 proteins on 5 different days) was significant for visual field deficit, and one for impaired fixation. No association was found between strabismus and any inflammatory mediator. Conclusion None of the three neuro-ophthalmologic dysfunctions assessed at two years appears to be associated with systemic inflammation measured the first four postnatal weeks.

Extremely Low Birth Weight and Accelerated Biological Aging

“…Early life adversity may also exert its influence on biological aging indirectly through associated mechanisms, such as systemic inflammation 56,57 and oxidative stress, 58 which have been implicated in both preterm birth and age-related decline. [59][60][61] The current findings suggestive of accelerated biological aging among men born at ELBW must be considered in light of this study's limitations.…”

Nursing In Front Of Technology As A Care Fundament On UTI Obstetric/Neonatal

“…It is noteworthy that with the passage of time and with technical and scientific advances, pediatrics gained a subgroup of specific knowledge, which was denominated Neonatology, defined as the knowledge of the human newborn; Not a system, but a whole that needs to be treated in this way [8].…”

“…However, even with the change in care to newborn delivery to the hospital setting and with all technological developments, there is still a difficulty in accessing quality health services for all women seeking care, high levels of maternal and neonatal morbidity and mortality, very high levels of operative delivery, most of the time without real indication, abusive use of the latest technology accelerating the process of evolution in disconnection with the reality necessary for this public [8,9].…”

“…All this technological apparatus provided a very noisy and noisy environment, requiring a greater number of professionals in intensive obstetric and neonatal care. We went from minimal manipulation to intervention and excessive manipulation of the team of intensivists [8].…”

“…The limit between normality and installed pathology is extremely tenuous and its imbalance represents a high risk of maternal-fetal morbidity and mortality. Thus, some factors may be present in order to become potential risks of complications to the health of the mother and/or child [8,20,21].…”