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OBJECTIVE. The aim of our study was to examine long-term effects of nephrocalcinosis in prematurely born children. PATIENTS AND METHODS. Preterm neonates (gestational age RESULTS. Blood pressure did not differ in ex-preterm infants with and without nephrocalcinosis but was significantly higher than expected for healthy children. In comparison to healthy children, more ex-preterm infants with neonatal nephrocalcinosis had (mild) chronic renal insufficiency (glomerular filtration rate: CONCLUSIONS. Nephrocalcinosis in preterm neonates can have long-term sequelae for glomerular and tubular function. Furthermore, prematurity per se is associated with high blood pressure, relatively small kidneys, and (distal) tubular dysfunction. Long-term follow-up of blood pressure and renal glomerular and tubular function of preterm neonates, especially with neonatal nephrocalcinosis, seems warranted., NEPHROCALCINOSIS, FIRST DESCRIBED in preterm neonates in 1982 by Hufnagle, was initially attributed to long-term furosemide therapy for chronic lung disease. (1) Since then, nephrocalcinosis was diagnosed in 7% to [...]

Objective. To determine changes in peri- and neonatal care concerning neonatal mortality and morbidity by comparing 2 cohorts of very prematurely born infants (gestational age [GA] Methods. The Leiden Follow-Up Project on Prematurity (LFUPP-1996/97), a regional, prospective study, includes all infants who were born alive after a GA Results. The absolute number of preterm births in the study region increased by 30%: 102 in 1983 to on average of 133 in 1996-1997. Centralization of perinatal care improved: the percentage of extrauterinely transported infants decreased from 61% in 1983 to 35% in 1996-1997. A total of 182 (73%) of the LFUPP-1996/97 infants were treated antenatally with glucocorticosteroids compared with 6 (6%) of the POPS-1983 infants. A total of 112 (42%) of the LFUPP-1996/97 infants received surfactant. In-hospital mortality decreased from 30% in the 1980s to 11% in the 1990s. Mortality of the extremely preterm infants ( Conclusions. An increase in the absolute number of very preterm births in this study region was found, leading to a greater burden on the regional NICUs. Improvements in peri- and neonatal care have led to an increased survival of especially extremely preterm infants. However, increased survival has resulted in more morbidity, mainly bronchopulmonary dysplasia, at the moment of discharge from the hospital. Pediatrics 2005;115:396-405; changes in peri- and neonatal care, time trend., ABBREVIATIONS. LFUPP, Leiden Follow-up Project on Prematurity; POPS, Project on Preterm and Small for Gestational Age Infants; GA, gestational age; SGA, small for gestational age; RDS, respiratory distress syndrome; BPD, [...]

Objective. To determine the outcome of infants with a gestational age (GA) Design. Regional, prospective study; part of the Leiden Follow-Up Project on Prematurity. Setting. Three health regions in The Netherlands. Patients. A total of 266 live born infants (1996/1997) with GA Main outcome measures. Neurologic examination (according to Hempel) and assessment of mental and psychomotor development using the Bayley Scales of Infant Development I, at the corrected age of 2 years. Results. Mortality was 35% (16 of 46) Conclusions. Mortality and neonatal morbidity were higher in infants with GA extremely premature infants, mortality, neonatal morbidity, neurologic outcome, psychomotor and mental development, behavior., ABBREVIATIONS. GA, gestational age; BPD, bronchopulmonary dysplasia; BSID, Bayley Scales of Infant Development; DA, definitely abnormal; IVH, intraventricular hemorrhage; LFUPP, Leiden Follow-Up Project on Prematurity; MA, mildly abnormal; MDI, mental [...]

The collaborative national survey on morbidity and mortality in preterm and small for gestational age infants in the Netherlands enrolled initially 1338 infants born in 1983. The relationship between maximal serum total bilirubin concentration in the neonatal period and neurodevelopmental outcome in the survivors of this cohort was studied. This relationship at the corrected age of 2 years was previously reported. A dose-response relationship between maximal serum total bilirubin concentration and risk of adverse outcome was observed in the 831 surviving children. The present study reassessed the relationship at the age of 5 years in 814 children. There was no significant difference in mean maximal serum total bilirubin concentration between the children with and without a handicap. This was confirmed by logistic regression analysis. After correction for seven suspected confounding factors (gestational age, birth weight, intracranial hemorrhage, ventriculomegaly, seizures, bronchopulmonary dysplasia, and socioeconomic status) the estimated odds ratio was 1.2 (confidence interval 0.89, 1.43) per 50 [mu]mo1/L increase of total bilirubin However, in this analysis an interaction between bilirubin and intracranial hemorrhage was observed. Therefore, the cohort was divided into two groups according to the absence or presence of an intracranial hemorrhage. Logistic regression analysis including four suspected confounding factors (gestational age, ventriculomegaly, seizures, and socioeconomic status) was then again applied. In children who had suffered from an intracranial hemorrhage in the neonatal period the estimated odds ratio was 1.84 (confidence interval 1.08, 3.15) per 50 [mu]mol/L increase of bilirubin. Similar results were obtained treating bilirubin as a categorized exposure. The odds ratio in children without a hemorrhage was 1.05 (confidence interval 0.80, 1.38), probably because of the small number of surviving handicapped children.

This study explored the effects of basic developmental care on the behaviour of very pre-term infants and parental stress at 1 and 2 years of corrected age. A randomized controlled trial was done to compare basic Developmental Care (standardized nests and incubator covers) and controls (standard care). Parents of infants born <32 weeks of gestation completed questionnaires measuring child behaviour and parental stress at 1 year (N = 139) and 2 years (N = 133) of the child's age. Parental stress was measured using the Nijmegen Parenting Stress Index and child behaviour was measured using the Infant-Toddler Social and Emotional Assessment (ITSEA) and the Child Behaviour Checklist 2-3. At 1 year of age, children in the basic developmental care group had significantly higher behaviour scores on the total competence domain (p = .009) and the competence subscale mastery motivation (p = .002) of the ITSEA questionnaire, meaning that the infants showed more curiosity, persistence, obedience and enjoyment with small accomplishments. No significant effects were found on problem behaviour or parenting stress. We conclude that introducing a basic form of developmental care in the neonatal intensive care unit has a positive influence on the child's competence behaviour at 1 year of age. [ABSTRACT FROM AUTHOR]