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1. ARBOVIROSES: INCIDÊNCIAS DE CASOS NOTIFICADOS DE DENGUE, ZIKA VÍRUS E CHIKUNGUNYA NO MUNICÍPIO DE PETRÓPOLIS - RJ NO PERÍODO DE 2011 - 2020

Author

Elaine Romano, TAMIRES DA SILVA COSTA, and REBECCA LEAL CAETANO

Abstract

Introdução: Arboviroses são as doenças causadas por arbovírus, cuja classificação engloba todos aqueles transmitidos por artrópodes, e as principais no Brasil são a dengue, a zika e chikungunya. Essas enfermidades são ocasionadas pelos vetores do gênero Aedes e espécies aegypti e albopictus. Possui afinidade com ambientes rurais e urbanos e a transmissão das doenças são provocadas pelo ciclo mosquito x homem x mosquito, tendo início quando o arbovírus sai do ciclo silvestre para o ciclo urbano. Doenças classificadas como tropicais e negligenciadas de grande preocupação no território brasileiro. São 36 arbovírus responsáveis por enfermidades em seres humanos. Acidentes ecológicos, desmatamentos e contaminações antrópicas facilitam o desenvolvimento das arboviroses principalmente em meio às grandes cidades, onde também a falta de saneamento básico e desigualdade social corroboram para que epidemias aconteçam com aumento de focos do mosquito, propiciando prolongamento do ciclo de transmissão, gerando um problema de Saúde Pública. Objetivo: Identificar e analisar a distribuição de incidência de casos notificados de arboviroses transmitidas por Aedes aegypti e Aedes albopictus nos 5 distritos do município de Petrópolis – RJ nos últimos 10 anos, comparando incidências entre os distritos com recursos estatísticos, realizando um levantamento dos principais aspectos socioambientais relacionados aos casos de arboviroses no município de Petrópolis. Material e Métodos: Dados do Sistema de Informação de Agravos de Notificação e bibliografias como sites do Ministério da Saúde, IBGE, FIOCRUZ, Secretarias de Saúde de Estados e Sociedade Brasileira de Imunizações foram utilizados para elaboração dos resultados. Resultados: Dengue e zika vírus aparecem com maior incidência de casos no ano de 2016, e chikungunya se destaca com altos números da doença no ano de 2019, predominantemente nos distritos mais populosos e urbanos da cidade. Para o expressivo aumento de casos dessas doenças nos anos de 2016 e 2019 podemos sugerir que acidentes ambientais como o rompimento das barragens de Mariana e Brumadinho podem ter causado desequilíbrio ambiental atingindo toda a Região Sudeste. Conclusão: A densidade demográfica e desastres ambientais facilitam a propagação dos arbovírus e a desigualdade social unindo-se a uma deficiência nas políticas sanitárias públicas podem contribuir para a evolução das epidemias de arboviroses.

Published
2022
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2. Early-Life Outcomes in Relation to Social Determinants of Health for Children Born Extremely Preterm

Author

Jane E. Brumbaugh, Betty R. Vohr, Edward F. Bell, Carla M. Bann, Colm P. Travers, Elisabeth C. McGowan, Heidi M. Harmon, Waldemar A. Carlo, Andrea F. Duncan, Susan R. Hintz, Alan H. Jobe, Michael S. Caplan, Richard A. Polin, Abbot R. Laptook, Martin Keszler, Angelita M. Hensman, Barbara Alksninis, Carmena Bishop, Robert T. Burke, Melinda Caskey, Laurie Hoffman, Katharine Johnson, Mary Lenore Keszler, Andrea M. Knoll, Vita Lamberson, Teresa M. Leach, Emilee Little, Bonnie E. Stephens, Elisa Vieira, Lucille St. Pierre, Suzy Ventura, Victoria E. Watson, Anna Maria Hibbs, Michele C. Walsh, Deanne E. Wilson-Costello, Nancy S. Newman, Monika Bhola, Allison H. Payne, Bonnie S. Siner, Gulgun Yalcinkaya, William E. Truog, Eugenia K. Pallotto, Howard W. Kilbride, Cheri Gauldin, Anne Holmes, Kathy Johnson, Allison Scott, Prabhu S. Parimi, Lisa Gaetano, Brenda B. Poindexter, Kurt Schibler, Suhas G. Kallapur, Edward F. Donovan, Stephanie Merhar, Cathy Grisby, Kimberly Yolton, Barbara Alexander, Traci Beiersdorfer, Kate Bridges, Tanya E. Cahill, Juanita Dudley, Estelle E. Fischer, Teresa L. Gratton, Devan Hayes, Jody Hessling, Lenora D. Jackson, Kristin Kirker, Holly L. Mincey, Greg Muthig, Sara Stacey, Jean J. Steichen, Stacey Tepe, Julia Thompson, Sandra Wuertz, C. Michael Cotten, Ronald N. Goldberg, Ricki F. Goldstein, William F. Malcolm, Deesha Mago-Shah, Patricia L. Ashley, Joanne Finkle, Kathy J. Auten, Kimberley A. Fisher, Sandra Grimes, Kathryn E. Gustafson, Melody B. Lohmeyer, Matthew M. Laughon, Carl L. Bose, Janice Bernhardt, Gennie Bose, Cindy Clark, Jennifer Talbert, Diane Warner, Andrea Trembath, T. Michael O'Shea, Janice Wereszczak, Stephen D. Kicklighter, Ginger Rhodes-Ryan, Donna White, Ravi M. Patel, David P. Carlton, Barbara J. Stoll, Ellen C. Hale, Yvonne C. Loggins, Ira Adams-Chapman, Ann Blackwelder, Diane I. Bottcher, Sheena L. Carter, Salathiel Kendrick-Allwood, Judith Laursen, Maureen Mulligan LaRossa, Colleen Mackie, Amy Sanders, Irma Seabrook, Gloria Smikle, Lynn C. Wineski, Rosemary D. Higgins, Andrew A. Bremer, Stephanie Wilson Archer, Gregory M. Sokol, Anna M. Dusick, Lu Ann Papile, Susan Gunn, Faithe Hamer, Dianne E. Herron, Abbey C. Hines, Carolyn Lytle, Lucy C. Miller, Heike M. Minnich, Leslie Richard, Lucy Smiley, Leslie Dawn Wilson, Jon E. Tyson, Kathleen A. Kennedy, Amir M. Khan, Andrea Duncan, Ricardo Mosquera, Emily K. Stephens, Georgia E. McDavid, Nora I. Alaniz, Elizabeth Allain, Julie Arldt-McAlister, Katrina Burson, Allison G. Dempsey, Elizabeth Eason, Patricia W. Evans, Carmen Garcia, Charles Green, Donna Hall, Beverly Foley Harris, Margarita Jiminez, Janice John, Patrick M. Jones, M. Layne Lillie, Anna E. Lis, Karen Martin, Sara C. Martin, Carrie M. Mason, Shannon McKee, Brenda H. Morris, Kimberly Rennie, Shawna Rodgers, Saba Khan Siddiki, Maegan C. Simmons, Daniel Sperry, Patti L. Pierce Tate, Sharon L. Wright, Pablo J. Sánchez, Leif D. Nelin, Sudarshan R. Jadcherla, Jonathan L. Slaughter, Keith O. Yeates, Sarah Keim, Nathalie L. Maitre, Christopher J. Timan, Patricia Luzader, Erna Clark, Christine A. Fortney, Julie Gutentag, Courtney Park, Julie Shadd, Margaret Sullivan, Melanie Stein, Mary Ann Nelin, Julia Newton, Kristi Small, Stephanie Burkhardt, Jessica Purnell, Lindsay Pietruszewski, Katelyn Levengood, Nancy Batterson, Pamela Morehead, Helen Carey, Lina Yoseff-Salameh, Rox Ann Sullivan, Cole Hague, Jennifer Grothause, Erin Fearns, Aubrey Fowler, Jennifer Notestine, Jill Tonneman, Krystal Hay, Michelle Chao, Kyrstin Warnimont, Laura Marzec, Bethany Miller, Demi R. Beckford, Hallie Baugher, Brittany DeSantis, Cory Hanlon, Jacqueline McCool, Abhik Das, Marie G. Gantz, Dennis Wallace, Margaret M. Crawford, Jenna Gabrio, David Leblond, Jamie E. Newman, Carolyn M. Petrie Huitema, Jeanette O'Donnell Auman, W. Kenneth Poole, Kristin M. Zaterka-Baxter, Krisa P. Van Meurs, Valerie Y. Chock, David K. Stevenson, Marian M. Adams, M. Bethany Ball, Barbara Bentley, Elizabeth Bruno, Alexis S. Davis, Maria Elena DeAnda, Anne M. DeBattista, Lynne C. Huffman, Magdy Ismael, Jean G. Kohn, Casey Krueger, Janice Lowe, Ryan E. Lucash, Andrew W. Palmquist, Jessica Patel, Melinda S. Proud, Elizabeth N. Reichert, Nicholas H. St. John, Dharshi Sivakumar, Heather L. Taylor, Natalie Wager, R. Jordan Williams, Hali Weiss, Ivan D. Frantz, John M. Fiascone, Brenda L. MacKinnon, Anne Furey, Ellen Nylen, Paige T. Church, Cecelia E. Sibley, Ana K. Brussa, Namasivayam Ambalavanan, Myriam Peralta-Carcelen, Kathleen G. Nelson, Kirstin J. Bailey, Fred J. Biasini, Stephanie A. Chopko, Monica V. Collins, Shirley S. Cosby, Kristen C. Johnston, Mary Beth Moses, Cryshelle S. Patterson, Vivien A. Phillips, Julie Preskitt, Richard V. Rector, Sally Whitley, Uday Devaskar, Meena Garg, Isabell B. Purdy, Teresa Chanlaw, Rachel Geller, Neil N. Finer, Yvonne E. Vaucher, David Kaegi, Maynard R. Rasmussen, Kathy Arnell, Clarence Demetrio, Martha G. Fuller, Wade Rich, Tarah T. Colaizy, John A. Widness, Michael J. Acarregui, Karen J. Johnson, Diane L. Eastman, Claire A. Goeke, Mendi L. Schmelzel, Jacky R. Walker, Michelle L. Baack, Laurie A. Hogden, Megan Broadbent, Chelsey Elenkiwich, Megan M. Henning, Sarah Van Muyden, Dan L. Ellsbury, Donia B. Campbell, Tracy L. Tud, Shahnaz Duara, Charles R. Bauer, Ruth Everett-Thomas, Sylvia Fajardo-Hiriart, Arielle Rigaud, Maria Calejo, Silvia M. Frade Eguaras, Michelle Harwood Berkowits, Andrea Garcia, Helina Pierre, Alexandra Stoerger, Kristi L. Watterberg, Janell Fuller, Robin K. Ohls, Sandra Sundquist Beauman, Conra Backstrom Lacy, Mary Hanson, Carol Hartenberger, Elizabeth Kuan, Jean R. Lowe, Rebecca A. Thomson, Sara B. DeMauro, Eric C. Eichenwald, Barbara Schmidt, Haresh Kirpalani, Aasma S. Chaudhary, Soraya Abbasi, Toni Mancini, Christine Catts, Noah Cook, Dara M. Cucinotta, Judy C. Bernbaum, Marsha Gerdes, Sarvin Ghavam, Hallam Hurt, Jonathan Snyder, Saritha Vangala, Kristina Ziolkowski, Carl T. D'Angio, Dale L. Phelps, Ronnie Guillet, Gary J. Myers, Michelle Andrews-Hartley, Julie Babish Johnson, Kyle Binion, Melissa Bowman, Elizabeth Boylin, Erica Burnell, Kelly R. Coleman, Cait Fallone, Osman Farooq, Julianne Hunn, Diane Hust, Rosemary L. Jensen, Rachel Jones, Jennifer Kachelmeyer, Emily Kushner, Deanna Maffett, Kimberly G. McKee, Joan Merzbach, Constance Orme, Diane Prinzing, Linda J. Reubens, Daisy Rochez, Mary Rowan, Premini Sabaratnam, Ann Marie Scorsone, Holly I.M. Wadkins, Kelley Yost, Lauren Zwetsch, Satyan Lakshminrusimha, Anne Marie Reynolds, Michael G. Sacilowski, Stephanie Guilford, Emily Li, Ashley Williams, William A. Zorn, Myra H. Wyckoff, Luc P. Brion, Walid A. Salhab, Charles R. Rosenfeld, Roy J. Heyne, Diana M. Vasil, Sally S. Adams, Lijun Chen, Maria M. De Leon, Francis Eubanks, Alicia Guzman, Gaynelle Hensley, Elizabeth T. Heyne, Lizette E. Lee, Melissa H. Leps, Linda A. Madden, E. Rebecca McDougald, Nancy A. Miller, Janet S. Morgan, Lara Pavageau, Pollieanna Sepulveda, Kristine Tolentino-Plata, Cathy Twell Boatman, Azucena Vera, Jillian Waterbury, Bradley A. Yoder, Mariana Baserga, Roger G. Faix, Sarah Winter, Stephen D. Minton, Mark J. Sheffield, Carrie A. Rau, Shawna Baker, Karie Bird, Jill Burnett, Susan Christensen, Laura Cole-Bledsoe, Brandy Davis, Jennifer O. Elmont, Jennifer J. Jensen, Manndi C. Loertscher, Jamie Jordan, Trisha Marchant, Earl Maxson, Kandace M. McGrath, Karen A. Osborne, D. Melody Parry, Brixen A. Reich, Susan T. Schaefer, Cynthia Spencer, Michael Steffen, Katherine Tice, Kimberlee Weaver-Lewis, Kathryn D. Woodbury, Karen Zanetti, Robert G. Dillard, Lisa K. Washburn, Barbara G. Jackson, Nancy Peters, Korinne Chiu, Deborah Evans Allred, Donald J. Goldstein, Raquel Halfond, Carroll Peterson, Ellen L. Waldrep, Cherrie D. Welch, Melissa Whalen Morris, Gail Wiley Hounshell, Seetha Shankaran, Beena G. Sood, Girija Natarajan, Athina Pappas, Katherine Abramczyk, Prashant Agarwal, Monika Bajaj, Rebecca Bara, Elizabeth Billian, Sanjay Chawla, Kirsten Childs, Lilia C. De Jesus, Debra Driscoll, Melissa February, Laura A. Goldston, Mary E. Johnson, Geraldine Muran, Bogdan Panaitescu, Jeannette E. Prentiss, Diane White, Eunice Woldt, John Barks, Stephanie A. Wiggins, Mary K. Christensen, Martha D. Carlson, Richard A. Ehrenkranz, Harris Jacobs, Christine G. Butler, Patricia Cervone, Sheila Greisman, Monica Konstantino, JoAnn Poulsen, Janet Taft, Joanne Williams, and Elaine Romano

Subjects
Pediatrics, Perinatology and Child Health
Published
2023
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3. Growth Rates of Infants Randomized to Continuous Positive Airway Pressure or Intubation After Extremely Preterm Birth

Author

Jean R. Lowe, Yvonne E. Vaucher, Ira Adams-Chapman, Elizabeth F. Bruno, Paul Zlotnik, Kristin M. Zaterka-Baxter, Nancy Close, Alicia Guzman, Susan R. Hintz, Amanda Soong, Wade Rich, Alexandra Stroerger, Seetha Shankaran, Saba Siddiki, Sharon L. Wright, Kimberlee Weaver-Lewis, Gary David Markowitz, Linda Black, Anne M. DeBattista, Donald J. Goldstein, Monika Bhola, Marcia Worley Mersmann, Brenda H. Morris, Vivek Narendran, Patricia L. Ashley, Theresa M. Leach, Barbara J. Stoll, Gail Hounshell, Kim Francis, M. Bethany Ball, Laura A. Goldston, Michele C. Walsh, Amy K. Hutchinson, Tarah T. Colaizy, David K. Stevenson, Lisa K. Washburn, Meghan Lukasik, Abhik Das, Linda J. Reubens, Maureen Mulligan LaRossa, Rene Barbieri-Welge, John M. Fiascone, Ann B. Cook, Jon E. Tyson, Carlos Torres, Renee Bridge, Melinda S. Proud, John A. Widness, Stephanie Wilson Archer, Kathleen G. Nelson, Kristi L. Watterberg, Katherine A. Foy, Abbot R. Laptook, Dan Gingras, Bradley A. Yoder, Michelle Harwood Berkowits, Richard A. Ehrenkranz, Janet Taft, Neil N. Finer, Fred J. Biasini, J. M. DiFiore, James P. Kiley, Anthony J. Piazza, Shahnaz Duara, William F. Malcolm, Lizette E. Torres, Kathy J. Auten, Dianne E. Herron, Mike Steffens, Nancy Peters, Sally Whitley, Nancy S. Newman, Charles R. Rosenfeld, Nancy A. Miller, Sarah Martin, Beverly Foley Harris, Conra Backstrom Lacy, Linda A. Madden, Gloria V. Smikle, Kathy Arnell, Kristen C. Johnston, Anna M. Dusick, Martha G. Fuller, Heike M. Minnich, Vineet Bhandari, Donna Posin, Kate Bridges, Martha R. Leonard, Roy J. Heyne, Noelle Younge, Christine G. Butler, Patricia Gettner, Carolyn M. Petrie Huitema, Sharon F. Freedman, Rachel V. Walden, Helina Pierre, Waldemar A. Carlo, Robert G. Dillard, Joanne Williams, Ellen Nylen, Margarita Jiminez, Victoria E. Watson, Sheena L. Carter, Richard V. Rector, Barbara Alksninis, David Wang, Bill Cashore, Kimberley A. Fisher, Susie Buchter, Michael J. Acarregui, Bonnie E. Stephens, Alexis N. Diaz, W. Kenneth Poole, Ana K. Brussa, Alexis S. Davis, Carolyn Lytle, Jill Burnett, Laura Grau, Bonnie S. Siner, Melissa Whalen Morris, Karen A. Osborne, Melinda Caskey, Cryshelle S. Patterson, Renee P. Pyle, Laura L. Whitely, Harriet Friedman, Sheree York, Kelley Yost, Emily Kushner, Rebecca Bara, Cathy Grisby, Arlene Zadell, Barbara D. Alexander, Ivan D. Frantz, Myriam Peralta-Carcelen, James W. Pickett, Karen J. Johnson, Sheila Greisman, Susan Barnett, Beena G. Sood, Ann M. Blackwelder, Catherine Twell Boatman, Gary J. Myers, Athina Pappas, Ariel A. Salas, Jean G. Kohn, Ayala Ben-Tall, Ellen C. Hale, Brenda B. Poindexter, Rosemary D. Higgins, Elisabeth Dinkins, Elizabeth T. Heyne, Teresa L. Gratton, Kerry Wilder, Jonathan W. Mink, Regina A. Gargus, Deanne E. Wilson-Costello, Rebecca Montman, Charles R. Bauer, Dale L. Phelps, Jamie E. Newman, Leslie Dawn Wilson, Pablo J. Sánchez, Alan H. Jobe, Monica Konstantino, Melody B. Lohmeyer, Monica V. Collins, Charles Green, Hali E. Weiss, Elizabeth Billian, Dorothy B. Gail, Clarence Demetrio, Kurt Schibler, Mary Anne Berberich, Leslie Rodriguez, David K. Wallace, Shabnam Lainwala, Betty R. Vohr, Sobha Fritz, Kasey Hamlin-Smith, William Oh, Deborah Pontillo, David P. Carlton, Cheryl Runyan, Arielle Riguard, Shawna Baker, Avroy A. Fanaroff, Sara Krzywanski, Shirley S. Cosby, Barbara Bentley, Gaynelle Hensley, Walid A. Salhab, Joan Merzbach, Cecelia E. Sibley, James Allen, Elaine Romano, C. Michael Cotten, Maria Hopkins, Vivien Phillips, Kimberly Yolton, Michael S. Caplan, Kathryn E. Gustafson, Andrea Milena Becerra Garcia, Kirstin J. Bailey, Margaret L. Poundstone, Diana M. Vasil, Cherrie D. Welch, Sarah Lillie, Ellen Waldrep, Jeanette O'Donnell Auman, Gulgun Yalcinkaya, Kalida Mehta, Patricia W. Evans, Harris Gelbard, Carroll Peterson, Angelita M. Hensman, Sylvia Hiriart-Fajardo, Edward F. Donovan, Barbara Do, James Wilkes, Marie G. Gantz, Nicholas H. St. John, Elaine O. Mathews, Harris C. Jacobs, Deborah Evans Allred, Rosemary L. Jensen, Suzy Ventura, Kathleen A. Kennedy, Dawn Andrews, Walter Gilliam, Kristen Angela, Mary Johnson, Katharine Johnson, Krisa P. Van Meurs, Barbara G. Jackson, Betty K. Hastings, Holly L. Mincey, Elisabeth C. McGowan, Brenda L. MacKinnon, JoAnn Poulsen, Pat Cervone, Edward F. Bell, T. Michael O'Shea, Janet S. Morgan, Elaine Ito, Julie Rohr, Ruth Everett-Thomas, Patti L. Pierce Tate, Laura Cole, Maria Calejo, Dennis Wallace, Paul Wozniak, Maynard Rasmussen, Robin K. Ohls, Lisa Augostino, Silvia M. Frade Eguaras, Faithe Hamer, Julie Babish Johnson, Karen Zanetti, Roger G. Faix, Maria Elena DeAnda, Ronald N. Goldberg, James A. Lemons, Diane Hust, Stacy Reddoch, Karie Bird, Jody Hessling, Araceli Solis, Carol J. Blaisdell, Raquel Halfond, Erica Burnell, Nirupama Laroia, Georgia E. McDavid, Namasivayam Ambalavanan, Sally S. Adams, Korinne Chiu, Cynthia Spencer, Lucy Noel, Melissa Martin, Nora I. Alaniz, James R. Moore, Ricki F. Goldstein, Janell Fuller, Melissa H. Lepps, Anne Furey, Diane L. Eastman, Jonathan M. Klein, and Anna E. Lis

Subjects
Male, Pediatrics, medicine.medical_specialty, Birth weight, medicine.medical_treatment, Gestational Age, Lower risk, Article, Child Development, Positive airway pressure, Intubation, Intratracheal, medicine, Humans, Intubation, Oximetry, Continuous positive airway pressure, Respiratory Distress Syndrome, Newborn, Continuous Positive Airway Pressure, business.industry, Infant, Newborn, Postmenstrual Age, Gestational age, Pulmonary Surfactants, Neurodevelopmental Disorders, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Gestation, Female, Energy Intake, business
Abstract

OBJECTIVE: To evaluate the effects of early treatment with CPAP on nutritional intake and in-hospital growth rates of extremely preterm (EPT) infants. STUDY DESIGN: EPT infants (24–0/7 to 27–6/7 weeks of gestation) enrolled in the Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT) were included. EPT infants who died before 36 weeks’ postmenstrual age (PMA) were excluded. The growth rates from birth to 36 weeks’ PMA and follow-up outcomes at 18–22 months’ corrected age of EPT infants randomized at birth to either early CPAP (intervention group) or early intubation for surfactant administration (control group) were analyzed. RESULTS: 810 of 1316 infants enrolled in SUPPORT (414 in intervention group, 396 in control group) had growth data analyzed. Median gestational age was 26 weeks and mean birthweight was 839 grams. Baseline characteristics, total nutritional intake, and in-hospital comorbidities were not significantly different between groups. In a regression model, growth rates between birth and 36 weeks’ PMA as well as growth rates during multiple intervals from birth to day 7, day 7 to14, day 14 to 21, day 21 to 28, day 28 to 32 weeks’ PMA, and 32 weeks’ PMA to 36 weeks’ PMA did not differ between treatment groups. Independent of treatment group, higher growth rates from day 21 to day 28 were associated with a lower risk of Bayley III cognitive score

Published
2021
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4. Developmental Outcomes of Extremely Preterm Infants with a Need for Child Protective Services Supervision

Author

Elisabeth C. McGowan, Abbot. R. Laptook, Jean Lowe, Myriam Peralta-Carcelen, Dhuly Chowdhury, Rosemary D. Higgins, Susan R. Hintz, Betty R. Vohr, Richard A. Polin, Abbott R. Laptook, Martin Keszler, Angelita M. Hensman, Barbara Alksninis, Kristin M. Basso, Robert Burke, Melinda Caskey, Katharine Johnson, Mary Lenore Keszler, Andrea M. Knoll, Theresa M. Leach, Emilee Little, Elisa Vieira, Victoria E. Watson, Suzy Ventura, Michele C. Walsh, Avroy A. Fanaroff, Anna Marie Hibbs, Deanne E. Wilson-Costello, Nancy S. Newman, Allison H. Payne, Bonnie S. Siner, Monika Bhola, Gulgun Yalcinkaya, Harriet G. Friedman, William E. Truog, Eugenia K. Pallotto, Howard W. Kilbride, Cheri Gauldin, Anne Holmes, Kathy Johnson, Allison Knutson, Kurt Schibler, Edward F. Donovan, Cathy Grisby, Kate Bridges, Barbara Alexander, Estelle E. Fischer, Holly L. Mincey, Jody Hessling, Teresa L. Gratton, Lenora Jackson, Kristin Kirker, Greg Muthig, Jean J. Steichen, Stacey Tepe, Kimberly Yolton, Ronald N. Goldberg, C. Michael Cotten, Ricki F. Goldstein, Patricia L. Ashley, William F. Malcolm, Kathy J. Auten, Kimberley A. Fisher, Sandra Grimes, Kathryn E. Gustafson, Melody B. Lohmeyer, Joanne Finkle, Matthew M. Laughon, Carl L. Bose, Janice Bernhardt, Gennie Bose, Cindy Clark, Linda Manor, Diane Warner, Janice Wereszczak, David P. Carlton, Barbara J. Stoll, Ira Adams-Chapman, Ellen C. Hale, Yvonne Loggins, Stephanie Wilson Archer, Gregory M. Sokol, Brenda B. Poindexter, Anna M. Dusick, Lu-Ann Papile, Susan Gunn, Faithe Hamer, Dianne E. Herron, Abbey C. Hines, Carolyn Lytle, Heike M. Minnich, Lucy Smiley, Leslie Dawn Wilson, Pablo J. Sanchez, Leif D. Nelin, Sudarshan R. Jadcherla, Patricia Luzader, Christine A. Fortney, Gail E. Besner, Nehal A. Parikh, Abhik Das, Dennis Wallace, Marie G. Gantz, W. Kenneth Poole, Jamie E. Newman, Jeanette O'Donnell Auman, Margaret M. Crawford, Carolyn M. Petrie Huitema, Kristin M. Zaterka-Baxter, Krisa P. Van Meurs, David K. Stevenson, M. Bethany Ball, Alexis S. Davis, Andrew W. Palmquist, Melinda S. Proud, Barbara Bentley, Elizabeth Bruno, Maria Elena DeAnda, Anne M. DeBattista, Beth Earhart, Lynne C. Huffman, Jean G. Kohn, Casey Krueger, Hali E. Weiss, Ivan D. Frantz, John M. Fiascone, Brenda L. MacKinnon, Anne Furey, Ellen Nylen, Waldemar A. Carlo, Namasivayam Ambalavanan, Monica V. Collins, Shirley S. Cosby, Fred J. Biasini, Kristen C. Johnston, Kathleen G. Nelson, Cryshelle S. Patterson, Vivien A. Phillips, Sally Whitley, Uday Devaskar, Meena Garg, Isabell B. Purdy, Teresa Chanlaw, Rachel Geller, Neil N. Finer, Yvonne E. Vaucher, David Kaegi, Maynard R. Rasmussen, Kathy Arnell, Clarence Demetrio, Martha G. Fuller, Wade Rich, Edward F. Bell, Tarah T. Colaizy, Michael J. Acarregui, Dan L. Ellsbury, John A. Widness, Karen J. Johnson, Donia B. Campbell, Diane L. Eastman, Jacky R. Walker, Jane E. Brumbaugh, Shahnaz Duara, Charles R. Bauer, Ruth Everett-Thomas, Sylvia Fajardo-Hiriart, Arielle Rigaud, Maria Calejo, Silvia M. Frade Eguaras, Michelle Harwood Berkowits, Andrea Garcia, Helina Pierre, Alexandra Stoerger, Kristi L. Watterberg, Jean R. Lowe, Janell F. Fuller, Robin K. Ohls, Conra Backstrom Lacy, Andrea F. Duncan, Rebecca Montman, Barbara Schmidt, Haresh Kirpalani, Sara B. DeMauro, Aasma S. Chaudhary, Soraya Abbasi, Toni Mancini, Dara M. Cucinotta, Judy C. Bernbaum, Marsha Gerdes, Hallam Hurt, Carl T. D'Angio, Dale L. Phelps, Ronnie Guillet, Satyan Lakshminrusimha, Julie Babish Johnson, Linda J. Reubens, Cassandra A. Horihan, Diane Hust, Rosemary L. Jensen, Emily Kushner, Joan Merzbach, Gary J. Myers, Mary Rowan, Holly I.M. Wadkins, Melissa Bowman, Julianne Hunn, Stephanie Guilford, Deanna Maffett, Farooq Osman, Diane Prinzing, Anne Marie Reynolds, Michael G. Sacilowski, Ashley Williams, Karen Wynn, Kelley Yost, William Zorn, Lauren Zwetsch, Kathleen A. Kennedy, Jon E. Tyson, Georgia E. McDavid, Nora I. Alaniz, Julie Arldt-McAlister, Katrina Burson, Patricia W. Evans, Carmen Garcia, Charles Green, Beverly Foley Harris, Margarita Jiminez, Janice John, Patrick M. Jones, Layne M. Lillie, Anna E. Lis, Karen Martin, Sara C. Martin, Brenda H. Morris, M. Layne Poundstone, Peggy Robichaux, Shawna Rodgers, Saba Siddiki, Maegan C. Simmons, Daniel Sperry, Patti L. Pierce Tate, Sharon L. Wright, Myra H. Wyckoff, Luc P. Brion, Roy J. Heyne, Walid A. Salhab, Charles R. Rosenfeld, Diana M. Vasil, Lijun Chen, Alicia Guzman, Gaynelle Hensley, Melissa H. Leps, Nancy A. Miller, Janet S. Morgan, Sally S. Adams, Catherine Twell Boatman, Elizabeth T. Heyne, Linda A. Madden, Lizette E. Torres, Roger G. Faix, Bradley A. Yoder, Karen A. Osborne, Cynthia Spencer, Kimberlee Weaver-Lewis, Shawna Baker, Karie Bird, Jill Burnett, Michael Steffen, Jennifer J. Jensen, Sarah Winter, Karen Zanetti, T. Michael O'Shea, Robert G. Dillard, Lisa K. Washburn, Barbara G. Jackson, Nancy Peters, Korinne Chiu, Deborah Evans Allred, Donald J. Goldstein, Raquel Halfond, Carroll Peterson, Ellen L. Waldrep, Cherrie D. Welch, Melissa Whalen Morris, Gail Wiley Hounshell, Seetha Shankaran, Athina Pappas, John Barks, Rebecca Bara, Laura A. Goldston, Girija Natarajan, Mary Christensen, Stephanie A. Wiggins, Diane White, Richard A. Ehrenkranz, Harris Jacobs, Christine G. Butler, Patricia Cervone, Sheila Greisman, Monica Konstantino, JoAnn Poulsen, Janet Taft, Joanne Williams, and Elaine Romano

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Time Factors, Birth weight, Gestational Age, Prenatal care, Article, 03 medical and health sciences, 0302 clinical medicine, Child Development, stomatognathic system, Pregnancy, 030225 pediatrics, medicine, Hospital discharge, Humans, 030212 general & internal medicine, School education, Retrospective Studies, business.industry, Extremely preterm, Child Protective Services, Infant, Newborn, Infant, Cognition, Prenatal Care, Patient Discharge, United States, stomatognathic diseases, Foster care, Increased risk, Child, Preschool, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Female, business, Follow-Up Studies
Abstract

OBJECTIVE: To evaluate neurodevelopmental outcomes of preterm infants with need for Child Protective Services (CPS) supervision at hospital discharge compared with those discharged without CPS supervision. STUDY DESIGN: For infants born at

Published
2019

5. Behavior Profiles at 2 Years for Children Born Extremely Preterm with Bronchopulmonary Dysplasia

Author

Jane E. Brumbaugh, Edward F. Bell, Scott F. Grey, Sara B. DeMauro, Betty R. Vohr, Heidi M. Harmon, Carla M. Bann, Matthew A. Rysavy, J. Wells Logan, Tarah T. Colaizy, Myriam A. Peralta-Carcelen, Elisabeth C. McGowan, Andrea F. Duncan, Barbara J. Stoll, Abhik Das, Susan R. Hintz, Michael S. Caplan, Richard A. Polin, Abbot R. Laptook, Martin Keszler, Angelita M. Hensman, Elisa Vieira, Emilee Little, Robert T. Burke, Bonnie E. Stephens, Barbara Alksninis, Carmena Bishop, Mary L. Keszler, Teresa M. Leach, Victoria E. Watson, Andrea M. Knoll, Michele C. Walsh, Avroy A. Fanaroff, Nancy S. Newman, Deanne E. Wilson-Costello, Allison Payne, Monika Bhola, Gulgun Yalcinkaya, Bonnie S. Siner, Harriet G. Friedman, Elizabeth Roth, William E. Truog, Eugenia K. Pallotto, Howard W. Kilbride, Cheri Gauldin, Anne Holmes, Kathy Johnson, Allison Knutson, Kurt Schibler, Brenda B. Poindexter, Stephanie Merhar, Kimberly Yolton, Teresa L. Gratton, Cathy Grisby, Kristin Kirker, Sandra Wuertz, David P. Carlton, Ira Adams-Chapman, Ellen C. Hale, Yvonne C. Loggins, Diane I. Bottcher, Colleen Mackie, Sheena L. Carter, Maureen Mulligan LaRossa, Lynn C. Wineski, Gloria V. Smikle, Angela Leon-Hernandez, Salathiel Kendrick-Allwood, C. Michael Cotten, Ronald N. Goldberg, Ricki F. Goldstein, William F. Malcolm, Patricia L. Ashley, Joanne Finkle, Kimberley A. Fisher, Sandra Grimes, Kathryn E. Gustafson, Matthew M. Laughon, Carl L. Bose, Janice Bernhardt, Gennie Bose, Diane Warner, Janice Wereszczak, Stephen D. Kicklighter, Ginger Rhodes-Ryan, Rosemary D. Higgins, Stephanie Wilson Archer, Gregory M. Sokol, Lu Ann Papile, Abbey C. Hines, Dianne E. Herron, Susan Gunn, Lucy Smiley, Kathleen A. Kennedy, Jon E. Tyson, Julie Arldt-McAlister, Katrina Burson, Allison G. Dempsey, Patricia W. Evans, Carmen Garcia, Margarita Jiminez, Janice John, Patrick M. Jones, M. Layne Lillie, Karen Martin, Sara C. Martin, Georgia E. McDavid, Shawna Rodgers, Saba Khan Siddiki, Daniel Sperry, Patti L. Pierce Tate, Sharon L. Wright, Pablo J. Sánchez, Leif D. Nelin, Sudarshan R. Jadcherla, Patricia Luzader, Christine A. Fortney, Gail E. Besner, Nehal A. Parikh, Dennis Wallace, Marie G. Gantz, Jamie E. Newman, Jeanette O'Donnell Auman, Margaret Crawford, Jenna Gabrio, David Leblond, Carolyn M. Petrie Huitema, Kristin M. Zaterka-Baxter, Krisa P. Van Meurs, Valerie Y. Chock, David K. Stevenson, Marian M. Adams, M. Bethany Ball, Barbara Bentley, Maria Elena DeAnda, Anne M. Debattista, Beth Earhart, Lynne C. Huffman, Magdy Ismael, Casey E. Krueger, Andrew W. Palmquist, Melinda S. Proud, Elizabeth N. Reichert, Meera N. Sankar, Nicholas H. St. John, Heather L. Taylor, Hali E. Weiss, Ivan D. Frantz, John M. Fiascone, Brenda L. MacKinnon, Ellen Nylen, Anne Furey, Cecelia E. Sibley, Ana K. Brussa, Waldemar A. Carlo, Namasivayam Ambalavanan, Kirstin J. Bailey, Fred J. Biasini, Monica V. Collins, Shirley S. Cosby, Vivien A. Phillips, Richard V. Rector, Sally Whitley, Uday Devaskar, Meena Garg, Isabell B. Purdy, Teresa Chanlaw, Rachel Geller, Neil N. Finer, Yvonne E. Vaucher, David Kaegi, Maynard R. Rasmussen, Kathy Arnell, Clarence Demetrio, Martha G. Fuller, Wade Rich, Radmila West, Michelle L. Baack, Dan L. Ellsbury, Laurie A. Hogden, Jonathan M. Klein, John M. Dagle, Karen J. Johnson, Tracy L. Tud, Chelsey Elenkiwich, Megan M. Henning, Megan Broadbent, Mendi L. Schmelzel, Jacky R. Walker, Claire A. Goeke, Kristi L. Watterberg, Robin K. Ohls, Conra Backstrom Lacy, Sandra Brown, Janell Fuller, Carol Hartenberger, Jean R. Lowe, Sandra Sundquist Beauman, Mary Ruffner Hanson, Tara Dupont, Elizabeth Kuan, Barbara Schmidt, Haresh Kirpalani, Aasma S. Chaudhary, Soraya Abbasi, Toni Mancini, Dara M. Cucinotta, Judy C. Bernbaum, Marsha Gerdes, Hallam Hurt, Carl T. D'Angio, Ronnie Guillet, Gary J. Myers, Satyan Lakshminrusimha, Anne Marie Reynolds, Michelle E. Hartley-McAndrew, Holly I.M. Wadkins, Michael G. Sacilowski, Linda J. Reubens, Rosemary L. Jensen, Joan Merzbach, William Zorn, Osman Farooq, Deanna Maffett, Ashley Williams, Julianne Hunn, Stephanie Guilford, Kelley Yost, Mary Rowan, Diane M. Prinzing, Karen Wynn, Cait Fallone, Ann Marie Scorsone, Myra H. Wyckoff, Luc P. Brion, Roy J. Heyne, Diana M. Vasil, Sally S. Adams, Lijun Chen, Maria M. De Leon, Frances Eubanks, Alicia Guzman, Elizabeth T. Heyne, Linda A. Madden, Nancy A. Miller, Lizette E. Lee, Lara Pavageau, Pollieanna Sepulveda, Cathy Twell Boatman, Roger G. Faix, Bradley A. Yoder, Mariana Baserga, Karen A. Osborne, Shawna Baker, Karie Bird, Jill Burnett, Susan Christensen, Brandy Davis, Jennifer O. Elmont, Jennifer J. Jensen, Manndi C. Loertscher, Trisha Marchant, Earl Maxson, Stephen D. Minton, D. Melody Parry, Carrie A. Rau, Susan T. Schaefer, Mark J. Sheffield, Cynthia Spencer, Mike Steffen, Kimberlee Weaver-Lewis, Sarah Winter, Kathryn D. Woodbury, Karen Zanetti, Seetha Shankaran, Sanjay Chawla, Beena G. Sood, Athina Pappas, Girija Natarajan, Monika Bajaj, Rebecca Bara, Mary E. Johnson, Laura Goldston, Stephanie A. Wiggins, Mary K. Christensen, Martha Carlson, John Barks, Diane F. White, Richard A. Ehrenkranz, Harris Jacobs, Christine G. Butler, Patricia Cervone, Sheila Greisman, Monica Konstantino, JoAnn Poulsen, Janet Taft, and Elaine Romano

Subjects
Male, Pediatrics, medicine.medical_specialty, CBCL, behavioral disciplines and activities, Language Development, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Cognition, 030225 pediatrics, mental disorders, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Child Behavior Checklist, Motor skill, Bronchopulmonary Dysplasia, Problem Behavior, business.industry, Confounding, Postmenstrual Age, Infant, Newborn, medicine.disease, Bronchopulmonary dysplasia, Motor Skills, Child, Preschool, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Infant Behavior, Gestation, Female, business
Abstract

To characterize behavior of 2-year-old children based on the severity of bronchopulmonary dysplasia (BPD).We studied children born at 22-26 weeks of gestation and assessed at 22-26 months of corrected age with the Child Behavior Checklist (CBCL). BPD was classified by the level of respiratory support at 36 weeks of postmenstrual age. CBCL syndrome scales were the primary outcomes. The relationship between BPD grade and behavior was evaluated, adjusting for perinatal confounders. Mediation analysis was performed to evaluate whether cognitive, language, or motor skills mediated the effect of BPD grade on behavior.Of 2310 children, 1208 (52%) had no BPD, 806 (35%) had grade 1 BPD, 177 (8%) had grade 2 BPD, and 119 (5%) had grade 3 BPD. Withdrawn behavior (P .001) and pervasive developmental problems (P .001) increased with worsening BPD grade. Sleep problems (P = .008) and aggressive behavior (P = .023) decreased with worsening BPD grade. Children with grade 3 BPD scored 2 points worse for withdrawn behavior and pervasive developmental problems and 2 points better for externalizing problems, sleep problems, and aggressive behavior than children without BPD. Cognitive, language, and motor skills mediated the effect of BPD grade on the attention problems, emotionally reactive, somatic complaints, and withdrawn CBCL syndrome scales (P values .05).BPD grade was associated with increased risk of withdrawn behavior and pervasive developmental problems but with decreased risk of sleep problems and aggressive behavior. The relationship between BPD and behavior is complex. Cognitive, language, and motor skills mediate the effects of BPD grade on some problem behaviors.

Published
2019

6. Timing of postnatal steroids for bronchopulmonary dysplasia: association with pulmonary and neurodevelopmental outcomes

Author

Heidi M, Harmon, Erik A, Jensen, Sylvia, Tan, Aasma S, Chaudhary, Jonathan L, Slaughter, Edward F, Bell, Myra H, Wyckoff, Angelita M, Hensman, Gregory M, Sokol, Sara B, DeMauro, and Elaine, Romano

Subjects
Male, Pediatrics, medicine.medical_specialty, Perinatal Death, Dexamethasone, Drug Administration Schedule, Infant Death, Article, Cohort Studies, Severe BPD, mental disorders, medicine, Odds Ratio, Humans, Glucocorticoids, Bronchopulmonary Dysplasia, Retrospective Studies, Respiratory Distress Syndrome, Newborn, business.industry, Postmenstrual Age, Age Factors, Infant, Newborn, Patient Acuity, Obstetrics and Gynecology, Gestational age, Infant, Retrospective cohort study, Odds ratio, medicine.disease, Infant mortality, Logistic Models, Bronchopulmonary dysplasia, nervous system, Neurodevelopmental Disorders, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Female, business, Cohort study
Abstract

Objective: To determine the associations between age at first postnatal corticosteroids (PNS) exposure and risk for severe bronchopulmonary dysplasia (BPD) and neurodevelopmental impairment (NDI). Study Design: Cohort study of 951 infants born

Published
2019

7. Association of Circulating Proinflammatory and Anti-inflammatory Protein Biomarkers in Extremely Preterm Born Children with Subsequent Brain Magnetic Resonance Imaging Volumes and Cognitive Function at Age 10 Years

Author

Beth Powers, Raina N. Fichorova, Adam Aakil, Julie Rathbun, Gail Hounshell, Jennifer DeRidder, Julie Vanier Rollins, Stephen C. Engelke, Jennifer Benjamin, Susan Barron, Hassan Y. Dawood, T. Michael O'Shea, Mitchell Horn, Forrest Beaulieu, Kathryn Mattern, Rosaria Rita Sassi, Suzanne Wiggins, Jenna-Malia Pasicznyk, Taryn Coster, Echo Meyer, Nigel Paneth, Sarah Nota, Aimee Asgarian, Nancy Darden-Saad, Anne M. Smith, Rachel Wilson, Deborah Weiland, Judith Klarr, Janice Ware, Ann Foley, Barbara Prendergast, Deborah Klein, Jean A. Frazier, Teri Crumb, Richard A. Ehrenkranz, Susan McQuiston, Patricia Brown, Brandi Hanson, David M. Cochran, Ellen C. Perrin, Madeleine Lenski, Jenifer Walkowiak, Brian Dessureau, Debbie Allred, Laurie M. Douglass, Emily Neger, Emily Ansusinha, Deborah Hirtz, Molly Wood, Lauren Venuti, Kirsten McGhee, Vanessa Tang, Timothy Heeren, Karen Bearrs, Sophy Kim, Damilola Junaid, Gary Stainback, Scott J. Hunter, Bhavesh Shah, Michael E. Msall, Susan Dieterich, Kathy Tsatsanis, Karl C.K. Kuban, Megan Scott, Elaine Romano, Megan Lloyd, Hidemi S. Yamamoto, Joni McKeeman, Kelly Vogt, Rachana Singh, Beth Kring, Patricia Lee, Ryan Martin, Robert M. Joseph, Anjali Sadhwani, Jackie Friedman, Hernan Jara, Khalid Alshamrani, Nancy Peters, Noah Beatty, Krissy Washington, Diane Warner, Jill Damon-Minow, Stanthia Ryan, Janice Bernhardt, Janice Wereszczak, Steve Pastyrnak, Katarzyna Chawarska, Rugile Ramoskaite, Ellen Waldrep, and Ngan Luu

Subjects
Male, medicine.medical_specialty, Cerebellum, Grey matter, Article, Proinflammatory cytokine, White matter, 03 medical and health sciences, 0302 clinical medicine, Cognition, 030225 pediatrics, Internal medicine, medicine, Humans, 030212 general & internal medicine, Nerve Growth Factors, Prospective Studies, Child, Inflammation, biology, business.industry, Infant, Newborn, Gestational age, Brain, Blood Proteins, Organ Size, Magnetic Resonance Imaging, medicine.anatomical_structure, Endocrinology, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, biology.protein, Female, Brainstem, business, Biomarkers, Neurotrophin
Abstract

OBJECTIVES: To examine elevated neonatal inflammatory and neurotrophic proteins from children born extremely preterm in relation to later childhood brain Magnetic Resonance Imaging volumes and cognition. STUDY DESIGN: We measured circulating inflammation-related proteins and neurotrophic proteins on postnatal days 1, 7, and 14 in 166 children at 10 years of age (73 males; 93 females). Top quartile levels on ≥2 days for ≥3 inflammation-related proteins and for ≥4 neurotrophic proteins defined exposure. We examined associations among protein levels, brain Magnetic Resonance Imaging volumes, and cognition with multiple linear and logistic regressions. RESULTS: Analyses were adjusted for gestational age at birth and sex. Children with ≥3 elevated inflammation-related proteins had smaller grey matter, brain stem/cerebellar, and total brain volumes than those without elevated inflammation-related proteins, adjusted for neurotrophic proteins. When adjusted for inflammation-related proteins, children with ≥4 neurotrophic proteins, compared with children with no neurotrophic proteins, had larger grey matter and total brain volumes. Higher grey matter, white matter, and cerebellum and brainstem volumes were significantly correlated with higher IQ. Grey and white matter volumes were correlated with each other (r = −0.18; P = .021), and cerebellum and brainstem was highly correlated with grey matter (r = 0.55; P < .001) and white matter (r = 0.29; P < .001). Adjusting for other brain compartments, cerebellum and brainstem was associated with IQ (P = .016), but the association with white matter was marginally significant (P = .051). Grey matter was not associated with IQ. After adjusting for brain volumes, elevated inflammation-related proteins remained significantly associated with a lower IQ, and elevated neurotrophic proteins remained associated with a higher IQ. CONCLUSIONS: Newborn inflammatory and neurotrophin protein levels are associated with later brain volumes and cognition, but their effects on cognition are not entirely explained by altered brain volumes.

Published
2019

8. Neurodevelopmental and Behavioral Outcomes in Extremely Premature Neonates With Ventriculomegaly in the Absence of Periventricular-Intraventricular Hemorrhage

Author

Heike M. Minnich, Ivan D. Frantz, Karen J. Johnson, William E Truog, Sandra Brown, Ronnie Guillet, Myriam Peralta-Carcelen, Rosemary D. Higgins, Haresh Kirpalani, Kathryn E. Gustafson, Leslie Dawn Wilson, Gregory M Sokol, Catherine Twell Boatman, Edward F. Bell, Janet S. Morgan, W. Kenneth Poole, Amanda D. Soong, Jeanette O'Donnell Auman, Avroy A. Fanaroff, Katrina Burson, Gulgun Yalcinkaya, Monica Konstantino, Leif D. Nelin, Bradley A. Yoder, Carin Kiser, Kristin M. Basso, Marian M. Adams, Neil N. Finer, Dennis Wallace, Hali E. Weiss, Deanna Maffett, Hallam Hurt, Fred J. Biasini, Meena Garg, Laura Cole, Kathleen A. Kennedy, Julianne Hunn, Lucy Miller, Anne Holmes, Farooq Osman, Barbara Schmidt, Anna Marie Hibbs, Walid A. Salhab, Karen A. Osborne, M. Bethany Ball, Laura A. Goldston, Silvia M. Frade Eguaras, Faithe Hamer, Julie Babish Johnson, Ruth Everett-Thomas, Patti L. Pierce Tate, Maria Calejo, Michele C. Walsh, Eugenia K. Pallotto, Rachel Geller, Roger G. Faix, Melissa H. Leps, Maria Elena DeAnda, Ronald N. Goldberg, Marie G. Gantz, Sally Whitley, Nehal A. Parikh, Michelle Harwood Berkowits, Seetha Shankaran, Andrew W. Palmquist, Andrea Halbrook, Kimberlee Weaver-Lewis, Theresa M. Leach, Ira Adams-Chapman, Janice Bernhardt, Sarah Ryan, Maynard Rasmussen, Edward F. Donovan, Diana M. Vasil, Carroll Peterson, Jamie E. Newman, Bonnie E. Stephens, Karen A. Wynn, Myra H. Wyckoff, David P. Carlton, Jody Hessling, Barbara Alexander, Katherine A. Foy, Abbot R. Laptook, Michael Steffen, Sudarshan R. Jadcherla, Suzy Ventura, Raquel Halfond, Ana K. Brussa, Charles R. Rosenfeld, Ellen Waldrep, Peggy Robichaux, Donald J. Goldstein, Monika Bhola, Brenda H. Morris, Clarence Demetrio, Erica Burnell, Brenda B. Poindexter, Martha D. Carlson, Sharon L. Wright, Linda A. Madden, Michael S. Caplan, Isabell B. Purdy, Athina Pappas, Barbara Bentley, Carol Hartenberger, Patricia W. Evans, John A. Widness, Marsha Gerdes, Stephanie Wilson Archer, Kimberly Yolton, Christine G. Butler, Roy J. Heyne, Joanne Williams, Gaynelle Hensley, Carl L. Bose, Lu Ann Papile, Richard A. Polin, Brenda L. MacKinnon, JoAnn Poulsen, Anne Marie Reynolds, T. Michael O'Shea, Charles R. Bauer, Gary J. Myers, Joanne Finkle, Maegan C. Simmons, Shahnaz Duara, Arielle Rigaud, Jill Burnett, Jacky R. Walker, Lauren Zwetsch, Ellen Nylen, Margarita Jiminez, Christine A. Fortney, Angelita M. Hensman, Ellen C. Hale, Joan Merzbach, Teresa L. Gratton, Yvonne E. Vaucher, Kathy Arnell, Holly I.M. Wadkins, Sara Kryzwanski, Nancy A. Miller, Susan R. Hintz, Elaine Romano, Betty R. Vohr, Sara B. DeMauro, Donia B. Campbell, Dara M. Cucinotta, Anna Bodnar, Kristy Domnanovich, Angela Argento, Georgia E. McDavid, Kurt Schibler, Patricia L. Ashley, Margaret M. Crawford, Casey E. Krueger, Bonnie S. Siner, Sally S. Adams, Jane E. Brumbaugh, Korinne Chiu, Janice Wereszczak, Satyanarayana Lakshminrusimha, Jon E. Tyson, Carolyn Lytle, Toni Mancini, Nancy Peters, Gennie Bose, Cryshelle S. Patterson, Katharine Johnson, Barbara J. Stoll, Kristin Kirker, Gail Hounshell, Melinda S. Proud, Janet Taft, Dale L. Phelps, Keith Owen Yeates, Kathy Johnson, Dan L. Ellsbury, Martin Keszler, Leslie Rodrigues, Jennifer J. Jensen, Barbara Alksninis, Sandra Grimes, Wade Rich, Stephanie A. Wiggins, Krisa P. Van Meurs, Yvonne Loggins, M. Layne Poundstone, David Kaegi, Elizabeth T. Heyne, Sheena L. Carter, Patricia Cervone, Richard V. Rector, John M. Fiascone, Nora I. Alaniz, Helina Pierre, Waldemar A. Carlo, Kimberley A. Fisher, Elisabeth C. McGowan, Robert G. Dillard, Greg Muthig, Sarah Martin, Carolyn M. Petrie Huitema, Barbara G. Jackson, Brian G. Tang, Melinda Caskey, Vivien Phillips, Soraya Abbasi, Michael J. Acarregui, Andrea Garcia, Robert T. Burke, Aasma S. Chaudhary, Luc P. Brion, Jean G. Kohn, Kelley Yost, Melody B. Lohmeyer, Allison F. Payne, Harriet Friedman, Victoria E. Watson, William Oh, Nancy S. Newman, John Barks, Andrea H. Duncan, Pablo J. Sánchez, Mary Lenore Keszler, Deborah Evans Allred, Rosemary L. Jensen, Karie Bird, Kristin M. Zaterka-Baxter, Ann B. Cook, Alicia Guzman, Holly L. Mincey, Gail E. Besner, Kate Bridges, Sylvia Fajardo-Hiriart, Matthew M. Laughon, Cathy Grisby, Robin K. Ohls, Rebecca Bara, Karen Zanetti, Anne M. DeBattista, Tarah T. Colaizy, William F. Malcolm, Cherrie D. Welch, Judy Bernbaum, Melissa Whalen Morris, Kathleen G. Nelson, Scott A. McDonald, Emily Kushner, Abbey C. Hines, Sheila Greisman, Ashley Williams, Estelle E. Fischer, Lenora Jackson, Harris C. Jacobs, Cheri Gauldin, Alexandra Stoerger, Deanne E. Wilson-Costello, Rebecca Montman, Monica V. Collins, Mary Christensen, Charles Green, Mary Johnson, David K. Stevenson, Lijun Chen, Cecelia E. Sibley, Lisa K. Washburn, Maureen Mulligan LaRossa, Lizette E. Torres, Kathy J. Auten, Chris Henderson, U. Devaskar, Leigh Ann Smith, Janell Fuller, Diane L. Eastman, Anna E. Lis, Dianne E. Herron, Kristen C. Johnston, Anna M. Dusick, Martha G. Fuller, Anne Furey, Howard W. Kilbride, Jean R. Lowe, Elizabeth F. Bruno, Saba Siddiki, Abhik Das, Linda J. Reubens, Richard A. Ehrenkranz, Namasivayam Ambalavanan, Cynthia Spencer, Ricki F. Goldstein, Lynne C. Huffman, Teresa Chanlaw, Patricia Luzader, Carl T. D'Angio, Diane Hust, Radmila West, Beverly Foley Harris, Sarah Winter, Conra Backstrom Lacy, Shawna Baker, Shirley S. Cosby, C. Michael Cotten, and Kristi L. Watterberg

Subjects
Male, Pediatrics, medicine.medical_specialty, Gestational Age, Infant, Premature, Diseases, Bayley Scales of Infant Development, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, medicine, Humans, Longitudinal Studies, Original Investigation, Cerebral Hemorrhage, Retrospective Studies, Ultrasonography, business.industry, Cerebral Palsy, Infant, Newborn, Gestational age, Brain, Gross Motor Function Classification System, Odds ratio, medicine.disease, Prognosis, Intraventricular hemorrhage, Bronchopulmonary dysplasia, Neurodevelopmental Disorders, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Necrotizing enterocolitis, Female, business, 030217 neurology & neurosurgery, Ventriculomegaly, Hydrocephalus
Abstract

Importance Studies of cranial ultrasonography and early childhood outcomes among cohorts of extremely preterm neonates have linked periventricular-intraventricular hemorrhage and cystic periventricular leukomalacia with adverse neurodevelopmental outcomes. However, the association between nonhemorrhagic ventriculomegaly and neurodevelopmental and behavioral outcomes is not fully understood. Objective To characterize the outcomes of extremely preterm neonates younger than 27 weeks’ gestational age who experienced nonhemorrhagic ventriculomegaly that was detected prior to 36 weeks’ postmenstrual age. Design, Setting, and Participants This longitudinal observational study was conducted at 16 centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants born prior to 27 weeks’ gestational age in any network facility between July 1, 2006, and June 30, 2011, were included if they had a cranial ultrasonogram performed prior to 36 weeks’ postmenstrual age. Comparisons were made between those with ventriculomegaly and those with normal cranial sonograms. Data analysis was completed from August 2013 to August 2017. Main Outcomes and Measures The main outcome was neurodevelopmental impairment, defined as a Bayley Scales of Infant and Toddler Development III cognitive score less than 70, moderate/severe cerebral palsy, a Gross Motor Function Classification System score of level 2 or more, vision impairment, or hearing impairment. Secondary outcomes included Bayley Scales of Infant and Toddler Development III subscores, components of neurodevelopmental impairment, behavioral outcomes, and death/neurodevelopmental impairment. Logistic regression was used to evaluate the association of ventriculomegaly with adverse outcomes while controlling for potentially confounding variables and center differences as a random effect. Linear regression was used similarly for continuous outcomes. Results Of 4193 neonates with ultrasonography data, 300 had nonhemorrhagic ventriculomegaly (7%); 3045 had normal cranial ultrasonograms (73%), 775 had periventricular-intraventricular hemorrhage (18.5%), and 73 had cystic periventricular leukomalacia (1.7%). Outcomes were available for 3008 of 3345 neonates with ventriculomegaly or normal scans (90%). Compared with normal cranial ultrasonograms, ventriculomegaly was associated with lower gestational age, male sex, and bronchopulmonary dysplasia, late-onset sepsis, meningitis, necrotizing enterocolitis, and stage 3 retinopathy of prematurity. After adjustment, neonates with ventriculomegaly had higher odds of neurodevelopmental impairment (odds ratio [OR], 3.07; 95% CI, 2.13-4.43), cognitive impairment (OR, 3.23; 95% CI, 2.09-4.99), moderate/severe cerebral palsy (OR, 3.68; 95% CI, 2.08-6.51), death/neurodevelopmental impairment (OR, 2.17; 95% CI, 1.62-2.91), but not death alone (OR, 1.09; 95% CI, 0.76-1.57). Behavioral outcomes did not differ. Conclusions and Relevance Nonhemorrhagic ventriculomegaly is associated with increased odds of neurodevelopmental impairment among extremely preterm neonates.

Published
2017

9. Antecedents of Screening Positive for Attention Deficit Hyperactivity Disorder in Ten-Year-Old Children Born Extremely Preterm

Author

Alan Leviton, Stephen R. Hooper, Scott J. Hunter, Megan N. Scott, Elizabeth N. Allred, Robert M. Joseph, T. Michael O'Shea, Karl Kuban, Janice Ware, Taryn Coster, Brandi Henson, Rachel Wilson, Kirsten McGhee, Patricia Lee, Aimee Asgarian, Anjali Sadhwani, Ellen Perrin, Emily Neger, Kathryn Mattern, Jenifer Walkowiak, Susan Barron, Jean Frazier, Lauren Venuti, Beth Powers, Ann Foley, Brian Dessureau, Molly Wood, Jill Damon-Minow, Richard Ehrenkranz, Jennifer Benjamin, Elaine Romano, Kathy Tsatsanis, Katarzyna Chawarska, Sophy Kim, Susan Dieterich, Karen Bearrs, Nancy Peters, Patricia Brown, Emily Ansusinha, Ellen Waldrep, Jackie Friedman, Gail Hounshell, Debbie Allred, Stephen C. Engelke, Nancy Darden-Saad, Gary Stainback, Diane Warner, Janice Wereszczak, Janice Bernhardt, Joni McKeeman, Echo Meyer, Steve Pastyrnak, Wendy Burdo-Hartman, Julie Rathbun, Sarah Nota, Teri Crumb, Madeleine Lenski, Deborah Weiland, Megan Lloyd, Scott Hunter, Michael Msall, Rugile Ramoskaite, Suzanne Wiggins, Krissy Washington, Ryan Martin, Barbara Prendergast, Megan Scott, Judith Klarr, Beth Kring, Jennifer DeRidder, and Kelly Vogt

Subjects
Male, Pediatrics, medicine.medical_specialty, Infant, Newborn, Diseases, Article, 03 medical and health sciences, 0302 clinical medicine, Developmental Neuroscience, Risk Factors, 030225 pediatrics, Epidemiology, medicine, Attention deficit hyperactivity disorder, Humans, Prospective Studies, Child, Socioeconomic status, business.industry, Incidence (epidemiology), Infant, Newborn, Gestational age, Retinopathy of prematurity, medicine.disease, Low birth weight, Neurology, Socioeconomic Factors, Attention Deficit Disorder with Hyperactivity, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Ventriculomegaly
Abstract

Background The incidence of attention deficit hyperactivity disorder is higher among children born very preterm than among children who are mature at birth. Methods We studied 583 ten-year-old children who were born before 28 weeks of gestation whose IQ was above 84 and had a parent-completed Child Symptom Inventory-4, which allowed classification of the child as having or not having symptoms of attention deficit hyperactivity disorder. For 422 children, we also had a teacher report, and for 583 children, we also had a parent report of whether or not a physician made an attention deficit hyperactivity disorder diagnosis. Results The risk profile of screening positive for attention deficit hyperactivity disorder based on a parent's report differed from the risk profile based on the teacher's report, whereas the risk profile according to a physician and according to any two observers closely resembled the parent-reported profile. Among the statistically significant risk factors were young maternal age (parent, physician, and two observers), maternal obesity (parent, physician, and two observers), maternal smoking (parent, physician, and two observers), magnesium given at delivery for seizure prophylaxis (parent and two observers), recovery of Mycoplasma sp. from the placenta (teacher and two observers), low gestational age (parent and two observers), low birth weight (teacher and physician), singleton (parent, physician, and two observers), male (parent, teacher, physician, and two observers), mechanical ventilation on postnatal day seven (physician), receipt of a sedative (parent and two observers), retinopathy of prematurity (parent), necrotizing enterocolitis (physician), antibiotic receipt (physician and two observers), and ventriculomegaly on brain scan (parent and two observers). Conclusions The multiplicity of risk factors identified can be subsumed as components of four broad themes: low socioeconomic state, immaturity or vulnerability, inflammation, and epigenetic phenomena.

Published
2017

10. Hand Preference and Cognitive, Motor, and Behavioral Functioning in 10-Year-Old Extremely Preterm Children

Author

Megan Lloyd, Richard A. Ehrenkranz, Judith Klarr, Jennifer DeRidder, Anjali Sadhwani, Jackie Friedman, Rachana Singh, Deborah Klein, Gary Stainback, Julie Vanier Rollins, Wendy Burdo-Hartman, Susan Barron, Echo Meyer, Aimee Asgarian, Sarah Nota, Steve Pastyrnak, Katarzyna Chawarska, Ellen C. Perrin, Brian Dessureau, Karl C.K. Kuban, Susan Dieterich, Brandi Henson, Joni McKeeman, Janice Ware, Beth Powers, Anne Smith, Karen Bearrs, Rugile Ramoskaite, Ellen Waldrep, Elizabeth N. Allred, Emily Neger, Jenifer Walkowiak, Michael E. Msall, Deborah Weiland, Elaine Romano, Kathy Tsatsanis, Patricia Lee, Kathryn Mattern, Scott J. Hunter, Bhavesh Shah, Sophy Kim, Ryan Martin, Suzanne Wiggins, Jill Damon-Minow, Jean A. Frazier, Nancy Darden-Saad, Janice Wereszczak, Molly Wood, T. Michael O'Shea, Nancy Peters, Rachel Wilson, Janice Bernhardt, Robert M. Joseph, Jennifer Benjamin, Ann Foley, Barbara Prendergast, Susan McQuiston, Laurie M. Douglass, Lauren Venuti, Kelly Vogt, Debbie Allred, Kirsten McGhee, Megan Scott, Peter J. Anderson, Beth Kring, Alice C. Burnett, Taryn Coster, Alan Leviton, Gail Hounshell, Stephen C. Engelke, Madeleine Lenski, Diane Warner, Krissy Washington, Julie Rathbun, Teri Crumb, Patricia Brown, and Emily Ansusinha

Subjects
Male, Hand preference, Child Behavior, Functional Laterality, Article, Odds, 03 medical and health sciences, 0302 clinical medicine, Cognition, 030225 pediatrics, Medicine, Humans, Prospective Studies, Association (psychology), Child, business.industry, Extremely preterm, Infant, Newborn, Motor Skills, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Female, business, 030217 neurology & neurosurgery, Clinical psychology, Follow-Up Studies
Abstract

The association of hand preference (left, mixed, and right) with cognitive, academic, motor, and behavioral function was evaluated in 864 extremely preterm children at 10 years of age. Left-handed and right-handed children performed similarly but mixed-handed children had greater odds of functional deficits across domains than right-handed children.

Published
2017

11. Neurocognitive Outcomes at 10 Years of Age in Extremely Preterm Newborns with Late-Onset Bacteremia

Author

Joni McKeeman, Anne Smith, Karl C.K. Kuban, Beth Powers, Nancy Peters, Patricia Lee, Deborah Weiland, Emily Neger, T. Michael O'Shea, Rachana Singh, Elaine Romano, Jill Damon-Minow, Jennifer DeRidder, Megan Lloyd, Sarah Nota, Sophy Kim, Teri Crumb, Richard A. Ehrenkranz, Janice Wereszczak, Janice Bernhardt, Jennifer Benjamin, Patricia Brown, Rachel Wilson, Ann Foley, Barbara Prendergast, Susan Barron, Steve Pastyrnak, Jenifer Walkowiak, Susan McQuiston, Rugile Ramoskaite, Ellen Waldrep, Emily Ansusinha, Nancy Darden-Saad, Michael E. Msall, Brandi Hanson, Ellen C. Perrin, Brian Dessureau, Gary Stainback, Kathy Tsatsanis, Madeleine Lenski, Anjali Sadhwani, Elizabeth N. Allred, Olaf Dammann, Katarzyna Chawarska, Jackie Friedman, Gail Hounshell, Megan Scott, Stephen C. Engelke, Aimee Asgarian, Debbie Allred, Kirsten McGhee, Kikelomo Babata, Ryan Martin, Janice Ware, Scott J. Hunter, Robert M. Joseph, Bhavesh Shah, H. Reeve Bright, Kelly Vogt, Alan Leviton, Beth Kring, Taryn Coster, Karen Bearrs, Susan Dieterich, Judith Klarr, Molly Wood, Deborah Klein, Carmina Erdei, Lauren Venuti, Kathryn Mattern, Suzanne Wiggins, Echo Meyer, Julie Rathbun, Krissy Washington, and Diane Warner

Subjects
Male, Pediatrics, medicine.medical_specialty, Birth weight, Developmental Disabilities, Late onset, Bacteremia, Infant, Premature, Diseases, Article, Sepsis, 03 medical and health sciences, Executive Function, 0302 clinical medicine, 030225 pediatrics, medicine, Humans, Child, business.industry, Extremely preterm, Confounding, Infant, Newborn, Gestational age, Infant, bacterial infections and mycoses, medicine.disease, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Female, business, Neurocognitive, 030217 neurology & neurosurgery
Abstract

To evaluate the difference in 10-year neurocognitive outcomes between extremely low gestational age newborns without bacteremia and those with suspected or confirmed late-onset bacteremia.Neurocognitive function was evaluated at 10 years of age in 889 children born at28 weeks of gestation and followed from birth. Definite (culture-positive) late-onset bacteremia during postnatal weeks 2-4 was identified in 223 children, and 129 children had suspected bacteremia.Infants with the lowest gestational age and birth weight z-score had the highest prevalence of definite and suspected late-onset bacteremia. Compared with peers with no or suspected bacteremia, infants with definite bacteremia performed worse on tests of general cognitive ability, language, academic achievement, and executive function, even after adjustment for potential confounders. Adjustment for low IQ attenuated the associations between bacteremia and all dysfunctions at age 10 years. Children with suspected bacteremia did not differ appreciably from those with no evidence of bacteremia. The motor domain was unaffected.Extremely low gestational age newborns who had definite late bacteremia during postnatal weeks 2-4 are at heightened risk of neurocognitive limitations at age 10 years.

Published
2016

12. The Relationship of Maternal Prepregnancy Body Mass Index and Pregnancy Weight Gain to Neurocognitive Function at Age 10 Years among Children Born Extremely Preterm

Author

Emily Neger, Sophy Kim, Jennifer Benjamin, Aimee Asgarian, Debbie Allred, Julie Rathbun, Rachel Wilson, Echo Meyer, Karl C.K. Kuban, Kirsten McGhee, Anjali Sadhwani, Ann Foley, Barbara Prendergast, Michael E. Msall, Jackie Friedman, Ellen C. Perrin, Brandi Henson, Kathy Tsatsanis, Patricia Lee, Janice Ware, Gary Stainback, Susan McQuiston, Judith Klarr, Deborah Klein, Jill Damon-Minow, Rugile Ramoskaite, Ellen Waldrep, Brian Dessureau, Jenifer Walkowiak, Krissy Washington, Janice Bernhardt, Nancy Darden-Saad, Jean A. Frazier, Scott J. Hunter, Bhavesh Shah, T. Michael O'Shea, Deborah Weiland, Thomas M. O'Shea, Timothy Heeren, Diane Warner, Beth Powers, Elizabeth N. Allred, Laurie M. Douglass, Lauren Venuti, Rachana Singh, Elizabeth T. Jensen, Sarah Nota, Kathryn Mattern, Nancy Peters, Suzanne Wiggins, Megan Lloyd, Jennifer DeRidder, Julie Vanier Rollins, Steve Pastyrnak, Teri Crumb, Susan Barron, Joni McKeeman, Anne Smith, Katarzyna Chawarska, Patricia Brown, Janice Wereszczak, Richard A. Ehrenkranz, Susan Dieterich, Emily Ansusinha, Molly Wood, Jelske W. van der Burg, Wendy Burdo-Hartman, Elaine Romano, Karen Bearrs, Kelly Vogt, Beth Kring, Taryn Coster, Ryan Martin, Robert M. Joseph, Alan Leviton, Megan Scott, Madeleine Lenski, Gail Hounshell, Stephen C. Engelke, and E&H: Environmental Health and Toxicology

Subjects
Male, Pediatrics, medicine.medical_specialty, Neurocognitive Disorders, Mothers, Extremely Premature, Weight Gain, Body Mass Index, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Child Development, SDG 3 - Good Health and Well-being, Pregnancy, Risk Factors, 030225 pediatrics, Journal Article, medicine, Humans, Obesity, Prospective Studies, Child, 030219 obstetrics & reproductive medicine, business.industry, Infant, Newborn, Gestational age, Wechsler Adult Intelligence Scale, Infant, Newborn, medicine.disease, Multicenter Study, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Cohort, Female, medicine.symptom, business, SDG 4 - Quality Education, Weight gain, Neurocognitive, Body mass index, Cohort study
Abstract

OBJECTIVE: To assess the association between maternal prepregnancy body mass index and adequacy of pregnancy weight gain in relation to neurocognitive function in school-aged children born extremely preterm.STUDY DESIGN: Study participants were 535 ten-year-old children enrolled previously in the prospective multicenter Extremely Low Gestational Age Newborns cohort study who were products of singleton pregnancies. Soon after delivery, mothers provided information about prepregnancy weight. Prepregnancy body mass index and adequacy of weight gain were characterized based on this information. Children underwent a neurocognitive evaluation at 10 years of age.RESULTS: Maternal prepregnancy obesity was associated with increased odds of a lower score for Differential Ability Scales-II Verbal IQ, for Developmental Neuropsychological Assessment-II measures of processing speed and visual fine motor control, and for Wechsler Individual Achievement Test-III Spelling. Children born to mothers who gained an excessive amount of weight were at increased odds of a low score on the Oral and Written Language Scales Oral Expression assessment. Conversely, children whose mother did not gain an adequate amount of weight were at increased odds of a lower score on the Oral and Written Language Scales Oral Expression and Wechsler Individual Achievement Test-III Word Reading assessments.CONCLUSION: In this cohort of infants born extremely preterm, maternal obesity was associated with poorer performance on some assessments of neurocognitive function. Our findings are consistent with the observational and experimental literature and suggest that opportunities may exist to mitigate risk through education and behavioral intervention before pregnancy.

Published
2016
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13. Extremely low gestational age and very low birthweight for gestational age are risk factors for autism spectrum disorder in a large cohort study of 10-year-old children born at 23-27 weeks' gestation

Author

Susan Dieterich, Gary Stainback, Ryan Martin, Robert M. Joseph, Beth Powers, Jennifer DeRidder, Susan Barron, Diane Warner, Jill Damon-Minow, Scott J. Hunter, Deborah Weiland, Jennifer Benjamin, T. Michael O'Shea, Katarzyna Chawarska, Steven J. Korzeniewski, Janice Bernhardt, Aimee Asgarian, Kelly Vogt, Joni McKeeman, Steve Pastyrnak, Beth Kring, Rachel Wilson, Krissy Washington, Ann Foley, Barbara Prendergast, Molly Wood, Janice Ware, Judith Klarr, Echo Meyer, Janice Wereszczak, Debbie Allred, Sarah Nota, Julie Rathbun, Kirsten McGhee, Richard A. Ehrenkranz, Brandi Henson, Wendy Burdo-Hartman, Jean A. Frazier, Emily Neger, Timothy Heeren, Rugile Ramoskaite, Ellen Waldrep, Michael E. Msall, Madeleine Lenski, Jenifer Walkowiak, Kathryn Mattern, Kathy Tsatsanis, Elaine Romano, Suzanne Wiggins, Sophy Kim, Gail Hounshell, Stephen C. Engelke, Megan Lloyd, Teri Crumb, Karl C.K. Kuban, Patricia Brown, Emily Ansusinha, Patricia Lee, Nancy Darden-Saad, Deborah Hirtz, Elizabeth N. Allred, Lauren Venuti, Taryn Coster, Karen Bearrs, Megan Scott, Ellen C. Perrin, Brian Dessureau, Nancy Peters, Alan Leviton, Anjali Sadhwani, and Jackie Friedman

Subjects
Male, Pediatrics, medicine.medical_specialty, Autism Spectrum Disorder, Gestational Age, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Risk Factors, 030225 pediatrics, Intellectual Disability, mental disorders, Intellectual disability, medicine, Humans, Infant, Very Low Birth Weight, Prospective Studies, Child, business.industry, Infant, Newborn, Obstetrics and Gynecology, Gestational age, Odds ratio, medicine.disease, Autism spectrum disorder, Infant, Small for Gestational Age, Small for gestational age, Autism, Female, business, 030217 neurology & neurosurgery, Cohort study, Follow-Up Studies
Abstract

No prospective cohort study of high-risk children has used rigorous exposure assessment and optimal diagnostic procedures to examine the perinatal antecedents of autism spectrum disorder separately among those with and without cognitive impairment.We sought to identify perinatal factors associated with increased risk for autism spectrum disorder with and without intellectual disability (intelligence quotient70) in children born extremely preterm.This prospective multicenter (14 institutions in 5 states) birth cohort study included children born at 23-27 weeks' gestation in 2002 through 2004 who were evaluated for autism spectrum disorder and intellectual disability at age 10 years. Pregnancy information was obtained from medical records and by structured maternal interview. Cervical-vaginal "infection" refers to maternal report of bacterial infection (n = 4), bacterial vaginosis (n = 30), yeast infection (n = 62), mixed infection (n = 4), or other/unspecified infection (n = 43; eg, chlamydia, trichomonas, or herpes). We do not know the extent to which infection per se was confirmed by microbial colonization. We use the terms "fetal growth restriction" and "small for gestational age" interchangeably in light of the ongoing challenge to discern pathologically from constitutionally small newborns. Severe fetal growth restriction was defined as a birthweight Z-score for gestational age at delivery-2 (ie, ≥2 SD below the median birthweight in a referent sample that excluded pregnancies delivered for preeclampsia or fetal indications). Participants were classified into 4 groups based on whether or not they met rigorous diagnostic criteria for autism spectrum disorder and intellectual disability (autism spectrum disorder+/intellectual disability-, autism spectrum disorder+/intellectual disability+, autism spectrum disorder-/intellectual disability+, and autism spectrum disorder-/intellectual disability-). Temporally ordered multinomial logistic regression models were used to examine the information conveyed by perinatal factors about increased risk for autism spectrum disorder and/or intellectual disability (autism spectrum disorder+/intellectual disability-, autism spectrum disorder+/intellectual disability+, and autism spectrum disorder-/intellectual disability+).In all, 889 of 966 (92%) children recruited were assessed at age 10 years, of whom 857 (96%) were assessed for autism spectrum disorder; of these, 840 (98%) children were assessed for intellectual disability. Autism spectrum disorder+/intellectual disability- was diagnosed in 3.2% (27/840), autism spectrum disorder+/intellectual disability+ in 3.8% (32/840), and autism spectrum disorder-/intellectual disability+ in 8.5% (71/840). Maternal report of presumed cervical-vaginal infection during pregnancy was associated with increased risk of autism spectrum disorder+/intellectual disability+ (odds ratio, 2.7; 95% confidence interval, 1.2-6.4). The lowest gestational age category (23-24 weeks) was associated with increased risk of autism spectrum disorder+/intellectual disability+ (odds ratio, 2.9; 95% confidence interval, 1.3-6.6) and autism spectrum disorder+/intellectual disability- (odds ratio, 4.4; 95% confidence interval, 1.7-11). Severe fetal growth restriction was strongly associated with increased risk for autism spectrum disorder+/intellectual disability- (odds ratio, 9.9; 95% confidence interval, 3.3-30), whereas peripartum maternal fever was uniquely associated with increased risk of autism spectrum disorder-/intellectual disability+ (odds ratio, 2.9; 95% confidence interval, 1.2-6.7).Our study confirms that low gestational age is associated with increased risk for autism spectrum disorder irrespective of intellectual ability, whereas severe fetal growth restriction is strongly associated with autism spectrum disorder without intellectual disability. Maternal report of cervical-vaginal infection is associated with increased risk of autism spectrum disorder with intellectual disability, and peripartum maternal fever is associated with increased risk for intellectual disability without autism spectrum disorder.

Published
2016

14. Among Children Born Extremely Preterm a Higher Level of Circulating Neurotrophins Is Associated with Lower Risk of Cognitive Impairment at School Age

Author

Aimee Asgarian, Megan Scott, Taryn Coster, Janice Ware, Ellen C. Perrin, Brian Dessureau, Jean A. Frazier, Damilola Junaid, Deborah Weiland, Beth Powers, Echo Meyer, Richard A. Ehrenkranz, H. Gerry Taylor, Hernan Jara, Raina N. Fichorova, Jenifer Walkowiak, Molly Wood, Ryan Martin, Joni McKeeman, Judith Klarr, Deborah Klein, Janice Wereszczak, Vanessa Tang, Anne Smith, Steve Pastyrnak, Laurie M. Douglass, Nancy Darden-Saad, Lauren Venuti, Timothy Heeren, Anjali Sadhwani, Jackie Friedman, Hidemi S. Yamamoto, Deborah Hirtz, Madeleine Lenski, Megan Lloyd, Kathryn Mattern, Jennifer DeRidder, Robert M. Joseph, Rugile Ramoskaite, Ellen Waldrep, Julie Vanier Rollins, Rosaria Rita Sassi, Suzanne Wiggins, T. Michael O'Shea, Ngan Luu, Susan Barron, Gail Hounshell, Hassan Y. Dawood, Karl C.K. Kuban, Karen Bearrs, Susan Dieterich, Stephen C. Engelke, Teri Crumb, Nancy Peters, Emily Neger, Sarah Nota, Jenna-Malia Pasicznyk, Katarzyna Chawarska, Elaine Romano, Rachel Wilson, Patricia Brown, Ann Foley, Barbara Prendergast, Susan McQuiston, Sophy Kim, Brandi Hanson, Debbie Allred, Kirsten McGhee, Emily Ansusinha, Jill Damon-Minow, Nigel Paneth, Stanthia Ryan, Scott J. Hunter, Bhavesh Shah, Janice Bernhardt, Michael E. Msall, Kathy Tsatsanis, Kelly Vogt, Beth Kring, Gary Stainback, Jennifer Benjamin, Julie Rathbun, Rachana Singh, Patricia Lee, Noah Beatty, Krissy Washington, and Diane Warner

Subjects
Male, Risk, 0301 basic medicine, T-Lymphocytes, Physiology, Lower risk, Severity of Illness Index, Article, Executive Function, 03 medical and health sciences, Child Development, Cognition, 0302 clinical medicine, Neurotrophic factors, Angiopoietin-1, Humans, Medicine, Nerve Growth Factors, Prospective Studies, Child, Chemokine CCL5, biology, business.industry, Brain-Derived Neurotrophic Factor, Infant, Newborn, Gestational age, Blood proteins, United States, Latent class model, 030104 developmental biology, Quartile, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, biology.protein, Female, Cognition Disorders, business, 030217 neurology & neurosurgery, Neurotrophin
Abstract

Objectives To test the hypothesis that higher blood levels of neurotrophic proteins (proteins that support neuronal survival and function) in the first 2 weeks of life are associated with a lower risk of cognitive impairment at 10 years. Study design We evaluated 812 10-year-old children with neonatal blood specimens enrolled in the multicenter prospective Extremely Low Gestational Age Newborn Study, assessing 22 blood proteins collected on 3 days over the first 2 weeks of life. Using latent profile analysis, we derived a cognitive function level based on standardized cognitive and executive function tests. We defined high exposure as the top quartile neurotrophic protein blood level on ≥2 days either for ≥4 proteins or for a specific cluster of neurotrophic proteins (defined by latent class analysis). Multinomial logistic regression analyzed associations between high exposures and cognitive impairment. Results Controlling for the effects of inflammatory proteins, persistently elevated blood levels of ≥4 neurotrophic proteins were associated with reduced risk of moderate (OR, 0.35; 95% CI, 0.18-0.67) and severe cognitive impairment (OR, 0.22; 95% CI, 0.09-0.53). Children with a cluster of elevated proteins including angiopoietin 1, brain-derived neurotrophic factor, and regulated upon activation, normal T-cell expressed, and secreted had a reduced risk of adverse cognitive outcomes (OR range, 0.31-0.6). The risk for moderate to severe cognitive impairment was least with 0-1 inflammatory and >4 neurotrophic proteins. Conclusions Persisting elevations of circulating neurotrophic proteins during the first 2 weeks of life are associated with lowered risk of impaired cognition at 10 years of age, controlling for increases in inflammatory proteins.

Published
2018
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15. Outcome of Preterm Infants with Transient Cystic Periventricular Leukomalacia on Serial Cranial Imaging Up to Term Equivalent Age

Author

Subrata Sarkar, Seetha Shankaran, John Barks, Barbara T. Do, Abbot R. Laptook, Abhik Das, Namasivayam Ambalavanan, Krisa P. Van Meurs, Edward F. Bell, Pablo J. Sanchez, Susan R. Hintz, Myra H. Wyckoff, Barbara J. Stoll, Waldemar A. Carlo, Alan H. Jobe, Michael S. Caplan, Richard A. Polin, Martin Keszler, William Oh, Betty R. Vohr, Angelita M. Hensman, Barbara Alksninis, Kristin M. Basso, Robert Burke, Melinda Caskey, Katharine Johnson, Mary Lenore Keszler, Andrea M. Knoll, Theresa M. Leach, Emilee Little, Elisabeth C. McGowan, Elisa Vieira, Victoria E. Watson, Suzy Ventura, Michele C. Walsh, Avroy A. Fanaroff, Anna Marie Hibbs, Deanne E. Wilson-Costello, Nancy S. Newman, Allison H. Payne, Bonnie S. Siner, Monika Bhola, Gulgun Yalcinkaya, Harriet G. Friedman, William E. Truog, Eugenia K. Pallotto, Howard W. Kilbride, Cheri Gauldin, Anne Holmes, Kathy Johnson, Allison Knutson, Kurt Schibler, Edward F. Donovan, Cathy Grisby, Kate Bridges, Barbara Alexander, Estelle E. Fischer, Holly L. Mincey, Jody Hessling, Teresa L. Gratton, Lenora Jackson, Kristin Kirker, Greg Muthig, Jean J. Steichen, Stacey Tepe, Marcia Worley Mersmann, Kimberly Yolton, Ronald N. Goldberg, C. Michael Cotten, Ricki F. Goldstein, Patricia L. Ashley, William F. Malcolm, Kathy J. Auten, Kimberley A. Fisher, Sandra Grimes, Kathryn E. Gustafson, Melody B. Lohmeyer, Joanne Finkle, Matthew M. Laughon, Carl L. Bose, Janice Bernhardt, Gennie Bose, Diane Warner, Janice Wereszczak, David P. Carlton, Ira Adams-Chapman, Ellen C. Hale, Yvonne Loggins, Ann M. Blackwelder, Diane I. Bottcher, Colleen Mackie, Rosemary D. Higgins, Stephanie Wilson Archer, Gregory M. Sokol, Brenda B. Poindexter, James A. Lemons, Anna M. Dusick, Lu-Ann Papile, Carolyn Lytle, Abbey C. Hines, Heike M. Minnich, Dianne E. Herron, Lucy Smiley, Susan Gunn, Leslie Dawn Wilson, Kathleen A. Kennedy, Jon E. Tyson, Georgia E. McDavid, Esther G. Akpa, Julie Arldt-McAlister, Nora I. Alaniz, Katrina Burson, Pamela J. Bradt, Susan Dieterich, Allison Dempsey, Andrea F. Duncan, Patricia W. Evans, Claudia I. Franco, Carmen Garcia, Charles Green, Beverly Foley Harris, Margarita Jiminez, Janice John, Patrick M. Jones, Layne M. Lillie, Anna E. Lis, Terri Major-Kincade, Karen Martin, Sara C. Martin, Brenda H. Morris, Patricia Ann Orekoya, Stacey Reddoch, Shawna Rodgers, Saba Siddiki, Maegan C. Simmons, Daniel Sperry, Patti L. Pierce Tate, Laura L. Whitely, Sharon L. Wright, Leif D. Nelin, Sudarshan R. Jadcherla, Patricia Luzader, Christine A. Fortney, Gail E. Besner, Nehal A. Parikh, Dennis Wallace, Marie G. Gantz, W. Kenneth Poole, Margaret M. Crawford, Jenna Gabrio, Betty K. Hastings, Jamie E. Newman, Jeanette O'Donnell Auman, Carolyn M. Petrie Huitema, Kristin M. Zaterka-Baxter, David K. Stevenson, M. Bethany Ball, Marian M. Adams, Alexis S. Davis, Andrew W. Palmquist, Melinda S. Proud, Barbara Bentley, Elizabeth Bruno, Maria Elena DeAnda, Anne M. DeBattista, Beth Earhart, Lynne C. Huffman, Jean G. Kohn, Casey Krueger, Hali E. Weiss, Ivan D. Frantz, John M. Fiascone, Brenda L. MacKinnon, Anne Furey, Ellen Nylen, Myriam Peralta-Carcelen, Monica V. Collins, Shirley S. Cosby, Fred J. Biasini, Kristen C. Johnston, Kathleen G. Nelson, Cryshelle S. Patterson, Vivien A. Phillips, Sally Whitley, Uday Devaskar, Meena Garg, Isabell B. Purdy, Teresa Chanlaw, Rachel Geller, Neil N. Finer, David Kaegi, Maynard R. Rasmussen, Paul R. Wozniak, Kathy Arnell, Clarence Demetrio, Martha G. Fuller, Chris Henderson, Wade Rich, Yvonne E. Vaucher, Tarah T. Colaizy, Michael J. Acarregui, Jane E. Brumbaugh, Dan L. Ellsbury, John A. Widness, Karen J. Johnson, Donia B. Campbell, Diane L. Eastman, Nancy J. Krutzfield, Shahnaz Duara, Charles R. Bauer, Ruth Everett-Thomas, Sylvia Fajardo-Hiriart, Arielle Rigaud, Maria Calejo, Silvia M. Frade Eguaras, Michelle Harwood Berkowits, Andrea Garcia, Helina Pierre, Alexandra Stoerger, Kristi L. Watterberg, Jean R. Lowe, Tara Dupont, Janell F. Fuller, Robin K. Ohls, Conra Backstrom Lacy, Rebecca Montman, Barbara Schmidt, Haresh Kirpalani, Sara B. DeMauro, Aasma S. Chaudhary, Soraya Abbasi, Toni Mancini, Dara M. Cucinotta, Judy C. Bernbaum, Marsha Gerdes, Hallam Hurt, Noah Cook, Carl T. D'Angio, Dale L. Phelps, Ronnie Guillet, Satyan Lakshminrusimha, Julie Babish Johnson, Erica Burnell, Linda J. Reubens, Cassandra A. Horihan, Rosemary L. Jensen, Emily Kushner, Joan Merzbach, Gary J. Myers, Mary Rowan, Holly I.M. Wadkins, Anne Marie Scorsone, Melissa Bowman, Julianne Hunn, Stephanie Guilford, Deanna Maffett, Osman Farooq, Diane Prinzing, Anne Marie Reynolds, Michael G. Sacilowski, Ashley Williams, Karen Wynn, Kelley Yost, William Zorn, Lauren Zwetsch, Luc P. Brion, R. Sue Broyles, Roy J. Heyne, Merle Ipson, Walid A. Salhab, Charles R. Rosenfeld, Diana M. Vasil, Lijun Chen, Alicia Guzman, Gaynelle Hensley, Jackie F. Hickman, Melissa H. Leps, Susie Madison, Nancy A. Miller, Janet S. Morgan, Lara Pavageau, Sally S. Adams, Cristin Dooley, Elizabeth T. Heyne, Lizette E. Lee, Linda A. Madden, Catherine Twell Boatman, Roger G. Faix, Bradley A. Yoder, Karen A. Osborne, Cynthia Spencer, Kimberlee Weaver-Lewis, Shawna Baker, Karie Bird, Jill Burnett, Michael Steffen, Jennifer J. Jensen, Sarah Winter, Karen Zanetti, T. Michael O'Shea, Robert G. Dillard, Lisa K. Washburn, Barbara G. Jackson, Nancy J. Peters, Korinne Chiu, Deborah Evans Allred, Donald J. Goldstein, Raquel Halfond, Carroll Peterson, Ellen L. Waldrep, Cherrie D. Welch, Melissa Whalen Morris, Gail Wiley Hounshell, Athina Pappas, Rebecca Bara, Laura A. Goldston, Geraldine Muran, Girija Natarajan, Mary Christensen, Stephanie A. Wiggins, Diane White, Richard A. Ehrenkranz, Harris Jacobs, Christine G. Butler, Patricia Cervone, Patricia Gettner, Sheila Greisman, Monica Konstantino, JoAnn Poulsen, Elaine Romano, Janet Taft, and Joanne Williams

Subjects
Male, congenital, hereditary, and neonatal diseases and abnormalities, Pediatrics, medicine.medical_specialty, Adverse outcomes, Developmental Disabilities, Leukomalacia, Periventricular, Gestational Age, Article, 03 medical and health sciences, Neonatal Screening, 0302 clinical medicine, Risk Factors, 030225 pediatrics, medicine, Humans, Prospective Studies, cardiovascular diseases, reproductive and urinary physiology, Ultrasonography, business.industry, Term equivalent age, Infant, Newborn, Brain, Infant, Cystic Periventricular Leukomalacia, nervous system diseases, Logistic Models, Increased risk, nervous system, Case-Control Studies, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Gestation, Female, business, 030217 neurology & neurosurgery
Abstract

OBJECTIVE: To determine the outcome of preterm infants whose cystic periventricular leukomalacia “disappeared” on serial screening cranial imaging studies. STUDY DESIGN: Infants ≤26 weeks of gestation born between 2002 and 2012 who had cranial imaging studies at least twice, the most abnormal study at

Published
2018
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16. Cranial Ultrasound Lesions in the NICU Predict Cerebral Palsy at Age 2 Years in Children Born at Extremely Low Gestational Age

Author

Karl C. K. Kuban, Nigel Paneth, Olaf Dammann, Stephen C. Engelke, Sjirk J. Westra, Padmani Karna, Elaine Romano, Cindy R. Miller, Adré J. du Plessis, Cecelia Keller, Elizabeth N. Allred, Marcello Pagano, Kalpathy S. Krishnamoorthy, Alan Leviton, Joseph Junewick, Daniel G. Batton, Haim Bassan, Sunila E. O'Connor, T. Michael O'Shea, Nicholas Olomu, and Joanna J. Seibert

Subjects
Male, Pediatrics, medicine.medical_specialty, Developmental Disabilities, Motor Activity, Article, Cerebral palsy, Cohort Studies, White matter, Intensive Care Units, Neonatal, Confidence Intervals, medicine, Humans, Prospective cohort study, Cerebral Hemorrhage, Ultrasonography, Neurologic Examination, medicine.diagnostic_test, business.industry, Cerebral Palsy, Infant, Newborn, Gestational age, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, Surgery, Intraventricular hemorrhage, Hemiparesis, medicine.anatomical_structure, Infant, Extremely Low Birth Weight, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, Neurology (clinical), medicine.symptom, business, Head, Psychomotor Performance, Ventriculomegaly
Abstract

Our prospective cohort study of extremely low gestational age newborns evaluated the association of neonatal head ultrasound abnormalities with cerebral palsy at age 2 years. Cranial ultrasounds in 1053 infants were read with respect to intraventricular hemorrhage, ventriculomegaly, and echolucency, by multiple sonologists. Standardized neurological examinations classified cerebral palsy, and functional impairment was assessed. Forty-four percent with ventriculomegaly and 52% with echolucency developed cerebral palsy. Compared with no ultrasound abnormalities, children with echolucency were 24 times more likely to have quadriparesis and 29 times more likely to have hemiparesis. Children with ventriculomegaly were 17 times more likely to have quadriparesis or hemiparesis. Forty-three percent of children with cerebral palsy had normal head ultrasound. Focal white matter damage (echolucency) and diffuse damage (late ventriculomegaly) are associated with a high probability of cerebral palsy, especially quadriparesis. Nearly half the cerebral palsy identified at 2 years is not preceded by a neonatal brain ultrasound abnormality.

Published
2009
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17. Very Low Birth Weight Preterm Infants With Surgical Short Bowel Syndrome: Incidence, Morbidity and Mortality, and Growth Outcomes at 18 to 22 Months

Author

Conrad R, Cole, Nellie I, Hansen, Rosemary D, Higgins, Thomas R, Ziegler, Barbara J, Stoll, and Elaine, Romano

Subjects
Adult, Male, Short Bowel Syndrome, Pediatrics, medicine.medical_specialty, Time Factors, Birth weight, Article, Child Development, Postoperative Complications, Enterocolitis, Necrotizing, Pregnancy, medicine, Humans, Infant, Very Low Birth Weight, Digestive System Surgical Procedures, Retrospective Studies, Enterocolitis, business.industry, Infant, Newborn, Infant, Gestational age, Short bowel syndrome, medicine.disease, United States, Survival Rate, Low birth weight, Malnutrition, Pediatrics, Perinatology and Child Health, Necrotizing enterocolitis, Female, Morbidity, medicine.symptom, business, Infant, Premature, Follow-Up Studies
Abstract

SHORT BOWEL SYNDROME (SBS) is a devastating clinical problem that affects an estimated 20 000 Americans (children and adults). Although not consistently fatal, complications that are associated with this disorder include dehydration, malnutrition, sepsis, poor growth, and impaired neurodevelopment.1-5 SBS is defined as insufficient bowel length to digest and absorb adequately nutrients that are needed to promote appropriate growth of the infant. SBS is often the result of massive small intestinal resection in infants as a result of necrotizing enterocolitis (NEC).6,7 Overall, the number of children with this disorder seems to be increasing, likely as a result of reductions in neonatal mortality in both term and preterm neonates, putting more infants at risk for developing diseases that predispose to SBS.8,9 The related health care costs that result from treating patients with SBS and its complications are very high. The quality-of-life burden on these children and their families is also very high.1,3 The most common cause of SBS in infants is NEC.10 The incidence of NEC in extremely low birth weight (ELBW) infants is ~10%, and the associated mortality is 30%.11,12 Infants who have NEC and are surgically treated have hospital lengths of stay that exceed those of gestational age (GA)-matched infants by 60 days. On the basis of this length of stay in 1 US hospital, the estimated hospital charges for infants with NEC exceeded those of matched control subjects by more than $186 000, and the yearly additional charges related to NEC were $6.5 million.13 Multiple factors have been identified as predictors of morbidity and mortality in patients with SBS14-16; however, SBS continues to constitute a major clinical challenge for neonatologists, gastroenterologists, and nutritionists, who often collectively treat these patients. It is associated with high morbidity and mortality because of chronic malabsorption that results from reduced bowel absorptive surface area and diminished mucosal function, including gut barrier dysfunction, frequent infections, and complications that are associated with specialized parenteral and enteral feeding.2,17 In children, SBS may lead to poor growth, nutritional deficiencies, delayed neurodevelopment, and ultimately death.18-20 Data illustrating the effect of SBS on subsequent growth and neurologic development in preterm infants are sparse.20-22 We determined the incidence of surgical SBS and examined morbidity, mortality, and growth outcomes of children with and without surgical SBS in a large cohort of very low birth weight (VLBW) infants who were born between 2002 and 2005.

Published
2008
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18. Growth Outcomes of Preterm Infants Exposed to Different Oxygen Saturation Target Ranges from Birth

Author

Cristina T. Navarrete, Lisa A. Wrage, Waldemar A. Carlo, Michele C. Walsh, Wade Rich, Marie G. Gantz, Abhik Das, Kurt Schibler, Nancy S. Newman, Anthony J. Piazza, Brenda B. Poindexter, Seetha Shankaran, Pablo J. Sánchez, Brenda H. Morris, Ivan D. Frantz, Krisa P. Van Meurs, C. Michael Cotten, Richard A. Ehrenkranz, Edward F. Bell, Kristi L. Watterberg, Rosemary D. Higgins, Shahnaz Duara, Marie Gantz, Alan H. Jobe, Michael S. Caplan, Avroy A. Fanaroff, Deanne E. Wilson-Costello, Bonnie S. Siner, Arlene Zadell, Julie DiFiore, Monika Bhola, Harriet G. Friedman, Gulgun Yalcinkaya, Edward F. Donovan, Vivek Narendran, Kimberly Yolton, Kate Bridges, Barbara Alexander, Cathy Grisby, Marcia Worley Mersmann, Holly L. Mincey, Jody Hessling, Teresa L. Gratton, Ronald N. Goldberg, Ricki F. Goldstein, Patricia Ashley, Kathy J. Auten, Kimberley A. Fisher, Katherine A. Foy, Sharon F. Freedman, Kathryn E. Gustafson, Melody B. Lohmeyer, William F. Malcolm, David K. Wallace, Barbara J. Stoll, Ira Adams-Chapman, Susie Buchter, David P. Carlton, Sheena Carter, Sobha Fritz, Ellen C. Hale, Amy K. Hutchinson, Maureen Mulligan LaRossa, Gloria V. Smikle, Stephanie Wilson Archer, Anna M. Dusick, James A. Lemons, Gary J. Myers, Leslie D. Wilson, Faithe Hamer, Ann B. Cook, Dianne E. Herron, Carolyn Lytle, Heike M. Minnich, Mary Anne Berberich, Carol J. Blaisdell, Dorothy B. Gail, James P. Kiley, W. Kenneth Poole, Jamie E. Newman, Betty K. Hastings, Jeanette O'Donnell Auman, Carolyn Petrie Huitema, James W. Pickett, Dennis Wallace, Kristin M. Zaterka-Baxter, David K. Stevenson, Susan R. Hintz, M. Bethany Ball, Barbara Bentley, Elizabeth F. Bruno, Alexis S. Davis, Maria Elena DeAnda, Anne M. DeBattista, Lynne C. Huffman, Jean G. Kohn, Melinda S. Proud, Renee P. Pyle, Nicholas H. St. John, Hali E. Weiss, John M. Fiascone, Elisabeth C. McGowan, Anne Furey, Brenda L. MacKinnon, Ellen Nylen, Ana Brussa, Cecelia Sibley, Namasivayam Ambalavanan, Myriam Peralta-Carcelen, Monica V. Collins, Shirley S. Cosby, Vivien A. Phillips, Kirstin J. Bailey, Fred J. Biasini, Maria Hopkins, Kristen C. Johnston, Sara Krzywanski, Kathleen G. Nelson, Cryshelle S. Patterson, Richard V. Rector, Leslie Rodriguez, Amanda Soong, Sally Whitley, Sheree York, John A. Widness, Michael J. Acarregui, Jonathan M. Klein, Tarah T. Colaizy, Karen J. Johnson, Diane L. Eastman, Charles R. Bauer, Ruth Everett-Thomas, Maria Calejo, Alexis N. Diaz, Silvia M. Frade Eguaras, Andrea Garcia, Kasey Hamlin-Smith, Michelle Harwood Berkowits, Sylvia Hiriart-Fajardo, Helina Pierre, Arielle Rigaud, Alexandra Stroerger, Robin K. Ohls, Janell Fuller, Julie Rohr, Conra Backstrom Lacy, Jean Lowe, Rebecca Montman, Luc Brion, Charles R. Rosenfeld, Walid A. Salhab, Roy J. Heyne, Sally S. Adams, James Allen, Lijun Chen, Laura Grau, Alicia Guzman, Gaynelle Hensley, Elizabeth T. Heyne, Jackie Hickman, Melissa H. Lepps, Linda A. Madden, Nancy A. Miller, Janet S. Morgan, Araceli Solis, Lizette E. Torres, Catherine Twell Boatman, Diana M Vasil, Kathleen A. Kennedy, Jon E. Tyson, Esther G. Akpa, Nora I. Alaniz, Susan Dieterich, Patricia W. Evans, Charles Green, Beverly Foley Harris, Margarita Jiminez, Anna E. Lis, Karen Martin, Sarah Martin, Georgia E. McDavid, M. Layne Poundstone, Stacey Reddoch, Saba Siddiki, Maegan C. Simmons, Patti L. Pierce Tate, Sharon L. Wright, Beena G. Sood, Athina Pappas, Rebecca Bara, Elizabeth Billian, Laura A. Goldston, Mary Johnson, Vineet Bhandari, Harris C. Jacobs, Pat Cervone, Patricia Gettner, Monica Konstantino, JoAnn Poulsen, Janet Taft, Christine G. Butler, Nancy Close, Walter Gilliam, Sheila Greisman, Elaine Romano, and Joanne Williams

Subjects
Male, Birth weight, Positive pressure, Growth, Article, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Fraction of inspired oxygen, Medicine, Humans, 030212 general & internal medicine, Oximetry, Oxygen saturation (medicine), business.industry, Postmenstrual Age, Infant, Newborn, Infant, Retinopathy of prematurity, Oxygenation, medicine.disease, Respiration, Artificial, Oxygen, Bronchopulmonary dysplasia, Anesthesia, Pediatrics, Perinatology and Child Health, Female, business, Infant, Premature
Abstract

To test whether infants randomized to a lower oxygen saturation (peripheral capillary oxygen saturation [SpO2]) target range while on supplemental oxygen from birth will have better growth velocity from birth to 36 weeks postmenstrual age (PMA) and less growth failure at 36 weeks PMA and 18-22 months corrected age.We evaluated a subgroup of 810 preterm infants from the Surfactant, Positive Pressure, and Oxygenation Randomized Trial, randomized at birth to lower (85%-89%, n = 402, PMA 26 ± 1 weeks, birth weight 839 ± 186 g) or higher (91%-95%, n = 408, PMA 26 ± 1 weeks, birth weight 840 ± 191 g) SpO2 target ranges. Anthropometric measures were obtained at birth, postnatal days 7, 14, 21, and 28; then at 32 and 36 weeks PMA; and 18-22 months corrected age. Growth velocities were estimated with the exponential method and analyzed with linear mixed models. Poor growth outcome, defined as weight10th percentile at 36 weeks PMA and 18-22 months corrected age, was compared across the 2 treatment groups by the use of robust Poisson regression.Growth outcomes including growth at 36 weeks PMA and 18-22 months corrected age, as well as growth velocity were similar in the lower and higher SpO2 target groups.Targeting different oxygen saturation ranges between 85% and 95% from birth did not impact growth velocity or reduce growth failure in preterm infants.

Published
2015

19. Impact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infants

Author

Tarah T. Colaizy, Melissa C. Bartick, Briana J. Jegier, Brittany D. Green, Arnold G. Reinhold, Andrew J. Schaefer, Debra L. Bogen, Eleanor Bimla Schwarz, Alison M. Stuebe, Alan H. Jobe, William Oh, Betty R. Vohr, Rachel V. Walden, Barbara Alksninis, Angelita M. Hensman, Martha R. Leonard, Lucy Noel, Teresa M. Leach, Victoria E. Watson, Avroy A. Fanaroff, Michele C. Walsh, Deanne E. Wilson-Costello, Nancy S. Newman, Bonnie S. Siner, Harriet G. Friedman, Edward F. Donovan, Kurt Schibler, Jean J. Steichen, Barbara Alexander, Cathy Grisby, Marcia Worley Mersmann, Holly L. Mincey, Jody Hessling, Teresa L. Gratton, Barbara J. Stoll, Ira Adams-Chapman, Ellen C. Hale, Maureen Mulligan LaRossa, Sheena Carter, Rosemary D. Higgins, Linda L. Wright, Elizabeth M. McClure, Brenda B. Poindexter, James A. Lemons, Anna M. Dusick, Darlene Kardatzke, Carolyn Lytle, Diana D. Appel, Lon G. Bohnke, Greg Eaken, Dianne E. Herron, Lucy C. Miller, Leslie Richard, Leslie Dawn Wilson, Abhik Das, W. Kenneth Poole, Lisa Ann Wrage, Betty K. Hastings, Jeanette O'Donnell Auman, Sarah Taylor, David K. Stevenson, Susan R. Hintz, M. Bethany Ball, Jean G. Kohn, Joan M. Baran, Julie C. Lee-Ancajas, Nicholas H. St. John, Waldemar A. Carlo, Namasivayam Ambalavanan, Kathleen G. Nelson, Myriam Peralta-Carcelen, Kirstin J. Bailey, Fred J. Biasini, Stephanie A. Chopko, Monica V. Collins, Shirley S. Cosby, Vivien A. Phillips, Richard V. Rector, Neil N. Finer, Yvonne E. Vaucher, Jack M. Anderson, Maynard R. Rasmussen, Kathy Arnell, Clarence Demetrio, Martha G. Fuller, Christopher Henderson, Donna Posin, Edward F. Bell, Charles R. Bauer, Shahnaz Duara, Amy Mur Worth, Ruth Everett-Thomas, Alexis N. Diaz, Elaine O. Mathews, Kasey Hamlin-Smith, Lisa Jean-Gilles, Maria Calejo, Silvia M. Frade, Silvia Hiriart-Fajardo, Yamiley Gideon, Sheldon B. Korones, Henrietta S. Bada, Tina Hudson, Kimberly Yolton, Marilyn G. Williams, Abbot R. Laptook, Walid A. Salhab, R. Sue Broyles, Susie Madison, Jackie F. Hickman, Alicia Guzman, Sally S. Adams, Linda A. Madden, Elizabeth T. Heyne, Cristin Dooley, Seetha Shankaran, Virginia Delaney-Black, Yvette R. Johnson, Rebecca Bara, Geraldine Muran, Deborah Kennedy, Laura A. Goldston, Richard A. Ehrenkranz, Patricia Gettner, Monica Konstantino, Elaine Romano, Nancy Close, Walter S. Gilliam, and JoAnn Poulsen

Subjects
Pediatrics, medicine.medical_specialty, Neonatal intensive care unit, Breastfeeding, Infant, Premature, Diseases, 03 medical and health sciences, 0302 clinical medicine, Enterocolitis, Necrotizing, 030225 pediatrics, medicine, Humans, 030212 general & internal medicine, Milk, Human, business.industry, Incidence (epidemiology), Postmenstrual Age, Infant, Newborn, Health Care Costs, medicine.disease, Infant mortality, digestive system diseases, Infant Formula, United States, Low birth weight, Breast Feeding, Models, Economic, Infant, Extremely Low Birth Weight, Pediatrics, Perinatology and Child Health, Cohort, Necrotizing enterocolitis, medicine.symptom, business, Monte Carlo Method, Infant, Premature
Abstract

Objective To estimate risk of necrotizing enterocolitis (NEC) for extremely low birth weight (ELBW) infants as a function of preterm formula (PF) and maternal milk intake and calculate the impact of suboptimal feeding on the incidence and costs of NEC. Study design We used aORs derived from the Glutamine Trial to perform Monte Carlo simulation of a cohort of ELBW infants under current suboptimal feeding practices, compared with a theoretical cohort in which 90% of infants received at least 98% human milk. Results NEC incidence among infants receiving ≥98% human milk was 1.3%; 11.1% among infants fed only PF; and 8.2% among infants fed a mixed diet ( P = .002). In adjusted models, compared with infants fed predominantly human milk, we found an increased risk of NEC associated with exclusive PF (aOR = 12.1, 95% CI 1.5, 94.2), or a mixed diet (aOR 8.7, 95% CI 1.2-65.2). In Monte Carlo simulation, current feeding of ELBW infants was associated with 928 excess NEC cases and 121 excess deaths annually, compared with a model in which 90% of infants received ≥98% human milk. These models estimated an annual cost of suboptimal feeding of ELBW infants of $27.1 million (CI $24 million, $30.4 million) in direct medical costs, $563 655 (CI $476 191, $599 069) in indirect nonmedical costs, and $1.5 billion (CI $1.3 billion, $1.6 billion) in cost attributable to premature death. Conclusions Among ELBW infants, not being fed predominantly human milk is associated with an increased risk of NEC. Efforts to support milk production by mothers of ELBW infants may prevent infant deaths and reduce costs.

Published
2015

20. Weight Status in the First 2 Years of Life and Neurodevelopmental Impairment in Extremely Low Gestational Age Newborns

Author

Mandy B. Belfort, Karl C.K. Kuban, T. Michael O'Shea, Elizabeth N. Allred, Richard A. Ehrenkranz, Stephen C. Engelke, Alan Leviton, Kathleen Lee, Anne McGovern, Jill Gambardella, Susan Ursprung, Ruth Blomquist Kristen Ecklund, Haim Bassan, Samantha Butler, Adré Duplessis, Cecil Hahn, Catherine Limperopoulos, Omar Khwaja, Janet S. Soul, Bhavesh Shah, Karen Christianson, Frederick Hampf, Herbert Gilmore, Susan McQuiston, Camilia R. Martin, Colleen Hallisey, Caitlin Hurley, Miren Creixell, Jane Share, Linda J. Van Marter, Sara Durfee, Robert M. Insoft, Jennifer G. Wilson, Maureen Pimental, Sjirk J. Westra, Kalpathy Krishnamoorthy, Cynthia Cole, John M. Fiascone, Janet Madden, Ellen Nylen, Anne Furey, Roy McCauley, Paige T. Church, Cecelia Keller, Karen J. Miller, Francis Bednarek, Mary Naples, Beth Powers, Jacqueline Wellman, Robin Adair, Richard Bream, Alice Miller, Albert Scheiner, Christy Stine, Richard Ehrenkranz, Joanne Williams, Elaine Romano, Cindy Miller, Nancy Close, Debbie Gordon, Teresa Harold, Barbara Specter, Deborah Allred, Robert Dillard, Don Goldstein, Deborah Hiatt, Gail Hounshell, Ellen Waldrep, Lisa Washburn, Cherrie D. Welch, Sherry Moseley, Linda Pare, Donna Smart, Joan Wilson, Ira Adler, Sharon Buckwald, Rebecca Helms, Kathyrn Kerkering, Scott S. MacGilvray, Peter Resnik, Carl Bose, Gennie Bose, Lynn A. Fordham, Lisa Bostic, Diane Marshall, Kristi Milowic, Janice Wereszczak, Mariel Poortenga, Dinah Sutton, Bradford W. Betz, Steven L. Bezinque, Joseph Junewick, Wendy Burdo-Hartman, Lynn Fagerman, Kim Lohr, Steve Pastyrnak, Carolyn Solomon, Ellen Cavenagh, Victoria J. Caine, Nicholas Olomu, Joan Price, Nigel Paneth, Padmani Karna, Madeleine Lenski, Michael D. Schreiber, Grace Yoon, Kate Feinstein, Leslie Caldarelli, Sunila E. O'Connor, Michael Msall, Susan Plesha-Troyke, Daniel Batton, Beth Kring, Karen Brooklier, Melisa J. Oca, and Katherine M. Solomon

Subjects
Male, Pediatrics, medicine.medical_specialty, Neonatal intensive care unit, Developmental Disabilities, Weight Gain, Article, 03 medical and health sciences, 0302 clinical medicine, Child Development, Risk Factors, 030225 pediatrics, medicine, Humans, Infant, Very Low Birth Weight, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, business.industry, Body Weight, Infant, Newborn, Gestational age, Infant, Gross Motor Function Classification System, Logistic Models, Quartile, Neurodevelopmental Disorders, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Cohort, Gestation, Female, medicine.symptom, business, Weight gain
Abstract

To examine the extent to which weight gain and weight status in the first 2 years of life relate to the risk of neurodevelopmental impairment in extremely preterm infants.In a cohort of 1070 infants born between 23 and 27 weeks' gestation, we examined weight gain from 7-28 days of life (in quartiles) and weight z-score at 12 and 24 months corrected age (in 4 categories:-2; ≥-2,-1; ≥1,1; and ≥1) in relation to these adverse neurodevelopmental outcomes: Bayley-II mental development index55, Bayley-II psychomotor development index55, cerebral palsy, Gross Motor Function Classification System ≥1 (cannot walk without assistance), microcephaly. We adjusted for confounders in logistic regression, stratified by sex, and performed separate analyses including the entire sample, and excluding children unable to walk without assistance (motor impairment).Weight gain in the lowest quartile from 7-28 days was not associated with higher risk of adverse outcomes. Children with a 12-month weight z-score-2 were at increased risk for all adverse outcomes in girls, and for microcephaly and Gross Motor Function Classification System ≥1 in boys. However, excluding children with motor impairment attenuated all associations except that of weight z-score-2 with microcephaly in girls. Similarly, most associations of low weight z-score at 24 months with adverse outcomes were attenuated with exclusion of children with motor impairment.Excluding children who have gross motor impairment appears to eliminate the association of low weight status with neurodevelopmental impairments at 2 years in extremely preterm infants.

Published
2015

21. Video and CD-ROM as a Training Tool for Performing Neurologic Examinations of 1-Year-Old Children in a Multicenter Epidemiologic Study

Author

Kim Lohr, Elizabeth N. Allred, Richard C. Bream, Lynn Fagerman, Janice Wereszczak, Robert G. Dillard, Carol Hubbard, Cherrie D. Heller, Padu Karna, Kathy Kerkering, Elaine Romano, Karen J. Miller, Adre J. duPlessis, Haim Bassan, Diane Marshall, Albert Scheiner, Paige Church, Robin Adair, Lisa K. Washburn, Dinah Sutton, Janet S. Soul, Nick Olomu, Steve Engelke, Alan Leviton, Kalpathy S. Krishnamoorthy, Michael A. O'Shea, Leslie Caldarelli, Alice Miller, Melisa J. Oca, Karl C. K. Kuban, Cecil D. Hahn, Cecelia Keller, Herbert E. Gilmore, Wendy Burdo-Hartman, Kristy Milowic, and Sunila E. O'Connor

Subjects
medicine.medical_specialty, Epidemiologic study, education, Video Recording, Education, Cerebral palsy, 03 medical and health sciences, Professional Competence, 0302 clinical medicine, 030225 pediatrics, Humans, Medicine, Neurologic Examination, Observer Variation, business.industry, Cerebral Palsy, Data Collection, Gold standard, Infant, Correct response, medicine.disease, Epidemiologic Studies, CD-ROM, Pediatrics, Perinatology and Child Health, Physical therapy, Neurologic examinations, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

In lieu of traditional training of examiners to identify cerebral palsy on a neurologic examination at age 1 year, we proposed an alternative approach using a multimedia training video and CD-ROM we developed after a two-step validation process. We hypothesized that use of CD-ROM interactive training will lead to reliable and valid performance of the neurologic examination by both pediatric neurologists and nonpediatric neurologists. All examiners were asked to take one of six interobserver variability tests found on the CD-ROM on two occasions. In the first interobserver variability evaluation, 89% (531 of 594) of the responses agreed with the gold standard responses. Following annotated feedback to the examiners about the two items that had a 60% correct rate, the correct response rate rose to 93% (114 of 123). In the second interobserver variability evaluation, 88% (493 of 560) of the responses agreed with the gold standard responses. Following annotated feedback to the examiners about the four items that had a 70% correct rate, the correct response rate rose to 96% (104 of 108). Interactive CD-ROM examination training is an efficient and cost-effective means of training both neurologists and non-neurologists to perform structured neurologic examinations in 1-year-old children. It provides an effective means to evaluate interobserver variability, offers a route for feedback, and creates an opportunity to reevaluate variability, both immediately and at periodic intervals. ( J Child Neurol 2005;20:829—831).

Published
2005
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22. Neurodevelopmental outcomes of extremely low-gestational-age neonates with low-grade periventricular-intraventricular hemorrhage

Author

Allison H, Payne, Susan R, Hintz, Anna Maria, Hibbs, Michele C, Walsh, Betty R, Vohr, Carla M, Bann, Deanne E, Wilson-Costello, and Elaine, Romano

Subjects
Adult, Male, Risk, Pediatrics, medicine.medical_specialty, Developmental Disabilities, Gross motor skill, Bayley Scales of Infant Development, Cerebral palsy, Risk Factors, medicine, Humans, Language Development Disorders, Longitudinal Studies, business.industry, Cerebral Palsy, Infant, Newborn, Gestational age, Infant, Odds ratio, medicine.disease, Echoencephalography, Cerebral Intraventricular Hemorrhage, United States, Motor Skills Disorders, Intraventricular hemorrhage, Child, Preschool, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Cohort, Multivariate Analysis, Female, business, Cognition Disorders, Intracranial Hemorrhages
Abstract

Importance Low-grade periventricular-intraventricular hemorrhage is a common neurologic morbidity among extremely low-gestational-age neonates, yet the outcomes associated with this morbidity are not fully understood. In a contemporary multicenter cohort, we evaluated the impact of such hemorrhages on early (18-22 month) neurodevelopmental outcomes of extremely premature infants. Objective To compare neurodevelopmental outcomes at 18 to 22 months' corrected age for extremely low-gestational-age infants with low-grade (grade 1 or 2) periventricular-intraventricular hemorrhage with those of infants with either no hemorrhage or severe (grade 3 or 4) hemorrhage demonstrated on cranial ultrasonography. Design Longitudinal observational study. Setting Sixteen centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Participants A total of 1472 infants born at less than 27 weeks' gestational age between January 1, 2006, and December 31, 2008, with ultrasonography results within the first 28 days of life and surviving to 18 to 22 months with complete follow-up assessments were eligible. Main Exposure Low-grade periventricular-intraventricular hemorrhage. Main Outcome Measures Outcomes included cerebral palsy; gross motor functional limitation; cognitive and language scores according to the Bayley Scales of Infant Development, 3rd Edition; and composite measures of neurodevelopmental impairment. Regression modeling evaluated the association of hemorrhage severity with adverse outcomes while controlling for potentially confounding variables and center differences. Results Low-grade hemorrhage was not associated with significant differences in unadjusted or adjusted risk of any adverse neurodevelopmental outcome compared with infants without hemorrhage. Compared with low-grade hemorrhage, severe hemorrhage was associated with decreased adjusted continuous cognitive (β, −3.91 [95% CI, −6.41 to −1.42]) and language (β, −3.19 [−6.19 to −0.19]) scores as well as increased odds of each adjusted categorical outcome except severe cognitive impairment (odds ratio [OR], 1.46 [0.74 to 2.88]) and mild language impairment (OR, 1.35 [0.88 to 2.06]). Conclusions and Relevance At 18 to 22 months, the neurodevelopmental outcomes of extremely low-gestational-age infants with low-grade periventricular-intraventricular hemorrhage are not significantly different from those without hemorrhage. Additional study at school age and beyond would be informative.

Published
2013

23. Girls and Boys Born before 28 Weeks Gestation: Risks of Cognitive, Behavioral, and Neurologic Outcomes at Age 10 Years

Author

Karl C.K. Kuban, Robert M. Joseph, Thomas M. O'Shea, Elizabeth N. Allred, Timothy Heeren, Laurie Douglass, Carl E. Stafstrom, Hernan Jara, Jean A. Frazier, Deborah Hirtz, Alan Leviton, Janice Ware, Taryn Coster, Brandi Hanson, Rachel Wilson, Kirsten McGhee, Patricia Lee, Aimee Asgarian, Anjali Sadhwani, Ellen Perrin, Emily Neger, Kathryn Mattern, Jenifer Walkowiak, Susan Barron, Bhavesh Shah, Rachana Singh, Anne Smith, Deborah Klein, Susan McQuiston, Lauren Venuti, Beth Powers, Ann Foley, Brian Dessureau, Molly Wood, Jill Damon-Minow, Richard Ehrenkranz, Jennifer Benjamin, Elaine Romano, Kathy Tsatsanis, Katarzyna Chawarska, Sophy Kim, Susan Dieterich, Karen Bearrs, Nancy Peters, Patricia Brown, Emily Ansusinha, Ellen Waldrep, Jackie Friedman, Gail Hounshell, Debbie Allred, Stephen C. Engelke, Nancy Darden-Saad, Gary Stainback, Diane Warner, Janice Wereszczak, Janice Bernhardt, Joni McKeeman, Echo Meyer, Steve Pastyrnak, Julie Rathbun, Sarah Nota, Teri Crumb, Madeleine Lenski, Deborah Weiland, Megan Lloyd, Scott Hunter, Michael Msall, Rugile Ramoskaite, Suzanne Wiggins, Krissy Washington, Ryan Martin, Barbara Prendergast, Megan Scott, Judith Klarr, Beth Kring, Jennifer DeRidder, and Kelly Vogt

Subjects
Male, Pediatrics, medicine.medical_specialty, Autism Spectrum Disorder, Population, Gestational Age, Neuropsychological Tests, Severity of Illness Index, Article, 03 medical and health sciences, Epilepsy, Sex Factors, 0302 clinical medicine, Seizures, 030225 pediatrics, Severity of illness, medicine, Humans, Mobility Limitation, Child, education, education.field_of_study, business.industry, Infant, Newborn, Gestational age, Cognition, Self-Help Devices, medicine.disease, United States, Neurodevelopmental Disorders, Autism spectrum disorder, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Cohort, Microcephaly, Autism, Female, Cognition Disorders, business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

Objectives To compare the prevalence of cognitive, neurologic, and behavioral outcomes at 10 years of age in 428 girls and 446 boys who were born extremely preterm. Study design A total of 889 of 966 eligible children previously enrolled in the multicenter Extremely Low Gestational Age Newborns Study from 2002-2004 were evaluated at 10 years of age. Children underwent a neuropsychological battery and testing for autism spectrum disorder (ASD), and parents reported on their child's behavior, development, and seizures. Results Of the children, 28% of boys and 21% of girls exhibited moderate to severe impairment on summary measures of cognitive abilities. Boys had a higher prevalence of impairment than girls in nearly all measures of cognition, were more than twice as likely to have microcephaly (15% in boys, 8% in girls), and require more often assistive devices to ambulate (6% in boys, 4% in girls). In contrast, boys and girls had comparable risk for a history of seizure (identified in 10% of the cohort) or epilepsy (identified in 7% of the cohort). The boy-to-girl ratio of ASD (9% in boys, 5% in girls) was lower than expected compared with the overall US autism population. Conclusions In this contemporary cohort of children born extremely premature and evaluated at school age, boys had higher prevalence of cognitive, neurologic, and behavioral deficits than girls. The ratio of boys to girls among those with ASD deserves further study as does the perinatal environmental-genetic interactions that might contribute to male preponderance of deficits in this high-risk sample.

Published
2016
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24. Outcome of extremely low birth weight infants who received delivery room cardiopulmonary resuscitation

Author

Myra H, Wyckoff, Walid A, Salhab, Roy J, Heyne, Douglas E, Kendrick, Barbara J, Stoll, Abbot R, Laptook, and Elaine, Romano

Subjects
Male, Pediatrics, medicine.medical_specialty, Birth weight, medicine.medical_treatment, Developmental Disabilities, education, Population, Gestational Age, Article, Cohort Studies, Pregnancy, Risk Factors, medicine, Birth Weight, Humans, Cardiopulmonary resuscitation, education.field_of_study, business.industry, Delivery Rooms, Infant, Newborn, Gestational age, medicine.disease, Prognosis, Cardiopulmonary Resuscitation, Survival Rate, Low birth weight, Treatment Outcome, Bronchopulmonary dysplasia, Infant, Extremely Low Birth Weight, Pediatrics, Perinatology and Child Health, Necrotizing enterocolitis, Female, medicine.symptom, business, Cohort study
Abstract

To determine whether delivery room cardiopulmonary resuscitation (DR-CPR) independently predicts morbidities and neurodevelopmental impairment (NDI) in extremely low birth weight infants.We conducted a cohort study of infants born with birth weight of 401 to 1000 g and gestational age of 23 to 30 weeks. DR-CPR was defined as chest compressions, medications, or both. Logistic regression was used to determine associations among DR-CPR and morbidities, mortality, and NDI at 18 to 24 months of age (Bayley II mental or psychomotor index70, cerebral palsy, blindness, or deafness). Data are adjusted ORs with 95% CIs.Of 8685 infants, 1333 (15%) received DR-CPR. Infants who received DR-CPR had lower birth weight (708±141 g versus 764±146g, P.0001) and gestational age (25±2 weeks versus 26±2 weeks, P.0001). Infants who received DR-CPR had more pneumothoraces (OR, 1.28; 95% CI, 1.48-2.99), grade 3 to 4 intraventricular hemorrhage (OR, 1.47; 95% CI, 1.23-1.74), bronchopulmonary dysplasia (OR, 1.34; 95% CI, 1.13-1.59), death by 12 hours (OR, 3.69; 95% CI, 2.98-4.57), and death by 120 days after birth (OR, 2.22; 95% CI, 1.93-2.57). Rates of NDI in survivors (OR, 1.23; 95% CI, 1.02-1.49) and death or NDI (OR, 1.70; 95% CI, 1.46-1.99) were higher for DR-CPR infants. Only 14% of DR-CPR recipients with 5-minute Apgar score2 survived without NDI.DR-CPR is a prognostic marker for higher rates of mortality and NDI for extremely low birth weight infants. New DR-CPR strategies are needed for this population.

Published
2011

25. Neonatal Cranial Ultrasound Lesions and Developmental Delays at 2 Years of Age Among Extremely Low Gestational Age Children

Author

Susan McQuiston, Susan Plesha-Troyke, T. Michael O'Shea, Sjirk J. Westra, Amanda Jacobson, Cecelia Keller, Donald J. Goldstein, Joan Price, Karl C.K. Kuban, Alan Leviton, Kara Brooklier, Marcello Pagano, Elizabeth N. Allred, Alice Miller, Nigel Paneth, Samantha C. Butler, Steve Pasternak, Katherine M. Solomon, Elaine Romano, Olaf Dammann, Gail Hounshell, and Lisa Bostic

Subjects
Pediatrics, medicine.medical_specialty, Developmental Disabilities, Birth weight, Gestational Age, Bayley Scales of Infant Development, Article, Diagnosis, Differential, Child Development, Cognition, Risk Factors, Humans, Medicine, Retrospective Studies, Psychomotor learning, Brain Diseases, Periventricular leukomalacia, business.industry, Infant, Newborn, Reproducibility of Results, Gestational age, medicine.disease, Echoencephalography, Vineland Adaptive Behavior Scale, Intraventricular hemorrhage, Infant, Extremely Low Birth Weight, Pediatrics, Perinatology and Child Health, business, Psychomotor Performance, Follow-Up Studies, Ventriculomegaly
Abstract

BACKGROUND. Studies of the relationship between ultrasound images from preterm newborns and developmental delay most often are based on small samples defined by birth weight and exclude infants not testable with standardized assessments.METHODS. We evaluated associations between ultrasound-defined lesions of the brain and developmental delays at 24 months’ corrected age in 1017 children born before the 28th postmenstrual week. Brain ultrasound scans were read for concordance on 4 lesions: intraventricular hemorrhage, moderate/severe ventriculomegaly, white matter echodense/hyperechoic lesions, and white matter echodense/hypoechoic lesions and 2 diagnoses–periventricular leukomalacia and periventricular hemorrhagic infarction. Certified examiners, who were not aware of the infants’ ultrasound findings, administered the Bayley Scales of Infant Development-Second Edition. Children with an impairment (eg., blindness) that precluded testing with the Bayley Scales and those for whom >2 test items were omitted were classified using the Vineland Adaptive Behavior Scales Motor Skills Domain instead of the Psychomotor Development Index and the Adaptive Behavior Composite instead of the Mental Development Index.RESULTS. Fully 26% of all of the children had delayed mental development (ie, Mental Development Index < 70), and 31% had delayed psychomotor development (ie, Psychomotor Development Index < 70). Ultrasound abnormalities were more strongly associated with low Psychomotor Development Index than with low Mental Development Index. Children without cranial ultrasound abnormality had the lowest probability (23% and 26%) of delayed mental or psychomotor development. Moderate/severe ventriculomegaly was associated with a more than fourfold increase in the risk of psychomotor delay and an almost threefold increase in the risk of mental delay. Echolucency was the next best predictor of delayed mental and psychomotor development. The probability of low scores varied with the number of zones involved and with the location of echolucency. At particularly high risk were infants with bilateral cerebellar hemorrhage, co-occurring ventriculomegaly and echolucency bilateral echolucency, or echolucency located posteriorly.CONCLUSIONS. Focal white matter damage, as characterized by echolucent/hypoechoic lesion, and diffuse damage, as suggested by late ventriculomegaly, are associated with delayed mental and psychomotor development.

Published
2008
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26. Neurodevelopmental outcome and growth at 18 to 22 months' corrected age in extremely low birth weight infants treated with early erythropoietin and iron

Author

Anna M. Dusick, Lu Ann Papile, Abhik Das, Neal P. Simon, Jean J. Steichen, Richard A. Ehrenkranz, Robin K. Ohls, Kimberly Yolton, Kimberly G. Lee, Virginia Delaney-Black, and Elaine Romano

Subjects
Male, Pediatrics, medicine.medical_specialty, Blood transfusion, Birth weight, medicine.medical_treatment, Iron, Growth, Placebo, Blindness, law.invention, Child Development, Randomized controlled trial, Double-Blind Method, law, Medicine, Body Size, Humans, Infant, Very Low Birth Weight, Blood Transfusion, Erythropoietin, Hearing Disorders, business.industry, Cerebral Palsy, Infant, Newborn, Infant, Clinical trial, Low birth weight, Pediatrics, Perinatology and Child Health, Female, medicine.symptom, Psychomotor Disorders, business, Psychomotor disorder, Infant, Premature, medicine.drug
Abstract

Background. Clinical trials evaluating the use of erythropoietin (Epo) have demonstrated a limited reduction in transfusions; however, long-term developmental follow-up data are scarce.Objective. We compared anthropometric measurements, postdischarge events, need for transfusions, and developmental outcomes at 18 to 22 months' corrected age in extremely low birth weight (ELBW) infants treated with early Epo and supplemental iron therapy with that of placebo/control infants treated with supplemental iron alone.Methods. The National Institute of Child Health and Human Development Neonatal Research Network completed a randomized, controlled trial of early Epo and iron therapy in preterm infants ≤1250 g. A total of 172 ELBW (≤1000-g birth weight) infants were enrolled (87 Epo and 85 placebo/control). Of the 72 Epo-treated and 70 placebo/control ELBW infants surviving to discharge, follow-up data (growth, development, rehospitalization, transfusions) at 18 to 22 months' corrected age were collected on 51 of 72 Epo-treated infants (71%) and 51 of 70 placebo/controls (73%) by certified examiners masked to the treatment group. Statistical significance was determined using χ2 analysis.Results. There were no significant differences between treatment groups in weight or length or in the percentage of infants weighing Conclusions. Treatment of ELBW infants with early Epo and iron does not significantly influence anthropometric measurements, need for rehospitalization, transfusions after discharge, or developmental outcome at 18 to 22 months' corrected age.

Published
2004

27. Outcomes of Small for Gestational Age Infants Born at <27 Weeks' Gestation

Author

Lilia C, De Jesus, Athina, Pappas, Seetha, Shankaran, Lei, Li, Abhik, Das, Edward F, Bell, Barbara J, Stoll, Abbot R, Laptook, Michele C, Walsh, Ellen C, Hale, Nancy S, Newman, Rebecca, Bara, Rosemary D, Higgins, and Elaine, Romano

Subjects
Male, congenital, hereditary, and neonatal diseases and abnormalities, Pediatrics, medicine.medical_specialty, Birth weight, Gestational Age, Infant, Premature, Diseases, Prenatal care, Risk Assessment, Article, Cohort Studies, Risk Factors, medicine, Humans, Growth Disorders, reproductive and urinary physiology, Retrospective Studies, Obstetrics, business.industry, Incidence, Incidence (epidemiology), Infant, Newborn, Infant, Gestational age, Retrospective cohort study, medicine.disease, female genital diseases and pregnancy complications, Infant, Small for Gestational Age, Pediatrics, Perinatology and Child Health, Gestation, Small for gestational age, Female, Nervous System Diseases, business, Infant, Premature, Cohort study
Abstract

To determine whether small for gestational age (SGA) infants born at27 weeks gestational age (GA) are at increased risk for mortality, morbidity, and growth and neurodevelopmental impairment at 18-22 months corrected age.This was a retrospective cohort study from National Institute of Child Health and Human Development Neonatal Research Network's Generic Database and Follow-Up Studies. Infants born at27 weeks GA between January 2006 and July 2008 were included. SGA was defined as birth weight10th percentile for GA based on Olsen growth curves. Infants with birth weight ≥ 10th percentile for GA were classified as non-SGA. Maternal and infant characteristics, neonatal outcomes, and neurodevelopmental data were compared in SGA and non-SGA infants. Neurodevelopmental impairment was defined as any of the following: cognitive score70 on the Bayley Scales of Infant Development III, moderate or severe cerebral palsy, bilateral hearing loss (with and without amplification), or blindness (bilateral vision20/200). Logistic regression analysis was applied to evaluate the associations between SGA status and death or neurodevelopmental impairment.The SGA group comprised 385 infants; the non-SGA group, 2586 infants. Compared with mothers of non-SGA infants, mothers of SGA infants were more likely to have a high school education, prenatal care, cesarean delivery, pregnancy-induced hypertension, and antenatal corticosteroid exposure. Compared with non-SGA infants, SGA infants had higher mortality and were more likely to have postnatal growth failure, prolonged mechanical ventilation, and postnatal steroid use. SGA status was associated with increased risk of death or neurodevelopmental impairment (OR, 3.91; 95% CI, 2.91-5.25; P.001).SGA status in infants born at27 weeks GA is associated with an increased likelihood of postnatal steroid use, mortality, growth failure, and neurodevelopmental impairment at 18-22 months corrected age.

Published
2013
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28. Hypocarbia and Adverse Outcome in Neonatal Hypoxic-Ischemic Encephalopathy

Author

Athina, Pappas, Seetha, Shankaran, Abbot R, Laptook, John C, Langer, Rebecca, Bara, Richard A, Ehrenkranz, Ronald N, Goldberg, Abhik, Das, Rosemary D, Higgins, Jon E, Tyson, Michele C, Walsh, and Elaine, Romano

Subjects
Male, Pediatrics, medicine.medical_specialty, Encephalopathy, Cumulative Exposure, Hypoxic Ischemic Encephalopathy, law.invention, Randomized controlled trial, Hypothermia, Induced, law, Intensive care, Humans, Medicine, Survival rate, Hypocapnia, business.industry, Infant, Newborn, Carbon Dioxide, Hypothermia, medicine.disease, United States, Survival Rate, Treatment Outcome, Anesthesia, Hypoxia-Ischemia, Brain, Pediatrics, Perinatology and Child Health, Female, medicine.symptom, Complication, business
Abstract

To evaluate the association between early hypocarbia and 18- to 22-month outcome among neonates with hypoxic-ischemic encephalopathy.Data from the National Institute of Child Health and Human Development Neonatal Research Network randomized, controlled trial of whole-body hypothermia for neonatal hypoxic-ischemic encephalopathy were used for this secondary observational study. Infants (n = 204) had multiple blood gases recorded from birth to 12 hours of study intervention (hypothermia versus intensive care alone). The relationship between hypocarbia and outcome (death/disability at 18 to 22 months) was evaluated by unadjusted and adjusted analyses examining minimum PCO(2) and cumulative exposure to PCO(2)35 mm Hg. The relationship between cumulative PCO(2)35 mm Hg (calculated as the difference between 35 mm Hg and the sampled PCO(2) multiplied by the duration of time spent35 mm Hg) and outcome was evaluated by level of exposure (none-high) using a multiple logistic regression analysis with adjustments for pH, level of encephalopathy, treatment group (± hypothermia), and time to spontaneous respiration and ventilator days; results were expressed as odds ratios and 95% confidence intervals. Alternative models of CO(2) concentration were explored to account for fluctuations in CO(2).Both minimum PCO(2) and cumulative PCO(2)35 mm Hg were associated with poor outcome (P.05). Moreover, death/disability increased with greater cumulative exposure to PCO(2)35 mm Hg.Hypocarbia is associated with poor outcome after hypoxic-ischemic encephalopathy.

Published
2011
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