An overview of risk factors for poor neurodevelopmental outcome associated with prematurity.
ABSTRACT BACKGROUND: Preterm birth is a major cause of neonatal mortality and morbidity. While advances in medical care have improved the survival of preterm infants, neurodevelopmental problems persist in this population. This article aims to review factors associated with their neurodevelopmental outcomes. DATA SOURCES: English language studies of neurodevelopmental outcomes in preterm infants were retrieved from PubMed. A total of 100 related publications were included. RESULTS: Early gestational age and birth weight are the most significant predictors of poor long-term neurological outcome. Structural changes of the brain, infection, male gender and neonatal intensive care unit course are also important factors affecting eventual outcome. Other complex biological and socio-economic factors, which extend from prenatal through postnatal periods, up through and including adulthood, also affect the trajectory of brain development in preterm infants. CONCLUSIONS: Neurodevelopmental problems continue to affect the preterm population. There is a critical need for collaboration among geneticists, obstetricians, pediatricians, and neuroimaging and rehabilitation experts to determine early predictive factors and neuroprotective therapies to properly treat or prevent poor neurodevelopmental outcomes in these infants.
- SourceAvailable from: Farin SoleimaniTehran University Medical Journal 01/2013; 71(9):551-61.
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ABSTRACT: Early identification and management of disabilities in children are essential to reduce long-term developmental sequelae. Many of the causes of hearing loss also produce cognitive delays resulting in a large number of children with both deafness and developmental disabilities. Children who have hearing loss and additional disabilities require complex, individualized therapy to maximize their long-term quality of life. Hearing loss is often detected early because of widespread newborn hearing screening programs and the decision for cochlear implantation in children presenting with multiple medical and developmental disorders is still evolving. This article will review the literature regarding cochlear implant considerations in children with additional developmental disabilities in areas of family perception, speech and language development, cognitive development including adaptive behavior and intelligence, communication and functional skills, auditory outcomes, quality of life outcomes, predictors of outcomes and realistic expectations after cochlear implantation.06/2013; 1(2):61-68. DOI:10.1007/s40136-013-0011-z
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ABSTRACT: AIM: To investigate iron status and developmental scores at six-years-of-age in a population with decreased prevalence of iron deficiency in infancy. Iron status at six years and tracking from 12 months were also studied. METHOD: Children (n=143) born in Iceland in 2005 were followed-up at the age of six. Motor and verbal development was assessed by a parental questionnaire and iron status was assessed by Hb, MCV and serum ferritin (SF). Iron depletion was defined as SF<15μg/l and deficiency as MCV<76 fl and SF<15 μg/l. RESULTS: Iron depletion was observed in 5.6% of six-year-olds and 1.4% were iron-deficient. Self-help (subset in motor development) differed by -4.14 (95% CI=-7.61,-0.67), between those iron depleted at 12 months (n=6) and those non-depleted (n=102), adjusted for maternal education. The combined motor developmental score seemed lower in iron depleted infants, although of borderline significance (p=0.066). MCV concentration tracked from 12 months to six years (r=0.31, p<0.002), but Hb and SF did not. CONCLUSION: Improved iron status at 12 months and six years has diminished the public health threat associated with iron depletion in the population studied but, iron depletion and development still associate weakly. Action to prevent iron depletion in infancy remains important. This article is protected by copyright. All rights reserved.Acta Paediatrica 06/2013; DOI:10.1111/apa.12316 · 1.84 Impact Factor