Monday, 31 March 2014 13:52

Preterm Infants: Visual Processing

An Australia research project looking at the long-term outcome of preterm birth on visual processing has found that despite advances in medical care improving the survival rate of high-risk extremely low birth weight and/or extremely preterm infants, visual morbidity is still relatively high compared with controls in late adolescence.

 

Ocular growth and development differ between extremely low birth weight (ELBW, ,1000 g) or extremely preterm (EP, gestational age ,28 weeks) and term children and may have long-term negative consequences for visual function. Visual sensory and perceptual skills are important for a range of functions and everyday activities, such as classroom learning, overall school performance,successful social interaction, and social cognition. Consequently, understanding the nature and frequency of visual deficits in ELBW/EP children is vital to inform adequate and appropriately targeted clinical follow-up and to increase focus on developing avenues for remediation.

The study involved following up 228 extremely preterm survivors born in Victoria in 1991 and 1992 and 166 randomly selected normal birth weight controls. The participants were assessed between the ages of 14 and 20 years of age. Visual acuity, stereopsis, convergence, color perception, and visual perception were assessed and contrasted between groups.

The researchers reported that adolescents born extemely preterm had worse visual acuity, poorer depth perception, and more problems with visual perception. Given the potential importance of visual perceptual skills to more complex tasks and academic achievement, these results have important clinical relevance.

Published in Industry News
Sunday, 29 January 2012 15:58

Steroids Help Micro Preemies

A recent study has found that treating women at risk of preterm birth as early as 22 to 23 weeks gestation improved the survival of extremely preterm infants. Babies born this early are colloquially called micro preemies. Due to extreme prematurity, micro preemies have a reduced chance of survival and are at increased risk for a number of health complications, such as respiratory distress syndrome, patent ductus artiosus, retinopathy of prematurity, necrotizing enterocolitis, and intraventricular hemorrhage.

Women who are at risk of preterm delivery are treated with antenatal corticosteroids (steroids for short) to help the infant’s immature lungs develop. Various studies have provided evidence for the effectiveness of steroids for decreasing mortality and morbidity in preterm infants. Typically, women at high risk of preterm birth between 24 to 34 weeks gestation are treated with steroids, however the use of steroids in women between 22 to 26 weeks gestation has been low and there is wide international and regional variation in their use. A research team in Japan sough to evaluate the effectiveness of antenatal corticosteroids to improve neonatal outcomes for infants born at less than 24 weeks of gestation. This was an important study as steroid use at this early stage may have large ramifications for survival and morbidity in the most vulnerable and tiniest of preterm babies.

The study involved the analysis of 11,607 infants born at 22 to 33 weeks gestation between 2003 and 2007. They evaluated the gestational age effects of treating women threatened with preterm birth with steroids on several factors related to neonatal morbidity and mortality. The most important finding of this study was that treatment with antenatal corticosteroids improved the survival of extremely preterm infants, including the tiniest micro preemies; babies born 22 to 23 weeks gestation.

Other results from the study demonstrated that steroid treatment was effective in decreasing respiratory distress syndrome, brain injury (intraventricular hemorrhage), surfactant use, and duration of oxygen use in preterm infants born between 24 and 29 weeks of gestation but not for the smaller micro preemies.

Published in Industry News
Wednesday, 14 May 2014 17:23

MRI, Extremely Preterm Birth & IQ

An Australia research group - Victorian Infant Collaborative Study - based in Melbourne investigates both short- and long-term outcomes associated with preterm birth. One of their studies has followed a large cohort, which includes participants from the 4 major children's hospitals in Victoria, 298 preterm survivors and 262 normal birth weight controls. These cohorts have had extensive evaluations of their growth and developments at 2, 5, and 8 years of age and were recently seen for a major follow-up including an extensive cognitive and visual assessment at age 8 years. In addition some 148 extremely preterm survivors and 132 term born controls received a magnetic resonance imaging scan of their brain in order to compare brain volumes from multiple brain tissues and structures as well as to explore the relationships of brain tissue volumes with IQ and basic educational skills.

IQ was assessed using the Wechsler Abbreviated Scale of Intelligence (WASI) and Educational skills were assessed using the Wide Range Achievement Test(WRAT-4).

This research represents the largest regional neuroimaging cohort of adolescents born in the 1990s, which is very important as this cohort represents a group that received "new" medical interventions such as surfactant therapy and antenatal corticosteroids which had greater success in improving survival rates of the smallest and most preterm infants. The long-term outcomes of these survivors have not been well documented until this unique study.

The researchers found that extremely preterm adolescents had smaller brain volumes, lower IQs and poorer educational performance than babies born at term. They also reported that brain volumes of multiple tissues and structures are related to IQ and educational outcomes and concluded that smaller total brain tissue volume is an important contributor to the cognitive and educational underperformance of adolescents born extremely preterm.

The authors of this study suggested that examining brain volume is one of many ways to understand the neurological changes associated with preterm birth and fruther investigations might be able to determine the correlation between other structural and functional information obtained from advanced MRI, which might also provide a more global understanding of changes related to extreme prematurity in adolescence

Published in Industry News

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Preemie, Premmie, or Prem?

Most babies spend between 38 and 42 weeks in their mother’s uterus. So, technically a preterm birth, preemie, premmie, or prem, is an infant who is born less than 37 completed gestational weeks. 


Read More: Defining Preterm birth


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