Friday, 23 November 2012 10:19

Brain Growth & Preemies

Neuroscientists in the US have found that the rate of brain growth in the weeks before preterm babies reach their expected due date is related to their cognitive (thinking and learning) abilities as children. It was found that between 24 to 44 weeks postmentrual age (PMA) that the rate of cerebral cortical growth is able to predict complex cognitive functioning but not motor skills in later childhood. Postmentrual age refers to your preemies gestational weeks plus their chronological age.

The study involved performing a magnetic resonance imaging (MRI) scan of the brain of 82 preterm infants up to 8 times. They also took part in a battery of neuropsychological tests at age 2 and 6 years.

The results indicate that the period before a full term brith, the last gestational weeks in the uterus, are critical for brain development, so for preemie babies the more the cerebral cortex grows early in life the better their outcome when they reach 6 years of age.

Published in Industry News
Sunday, 01 June 2014 11:40

Stem Cells Could Help Preterm Infants

Premature babies have underdeveloped lungs and often have difficulty breathing by themselves. Respiratory distress syndrome and chronic lung disease are the most common breathing difficulties related to preterm birth.

Difficulty breathing due to underdeveloped lungs is often a common consequence of preterm birth that needs immediate attention. Respiratory distress syndrome, also called hyaline membrane disease (HMD), is the most common lung disorder in preterm infants. Preterm infants do not produce enough of a slippery, protective substance called surfactant, which helps the lungs inflate with air and keeps them from collapsing, when the infant tries to breathe in air, after birth, by themself. Preterm infants with respiratory distress syndrome are treated with exogenous surfactant and has been shown to decrease neonatal mortality in very low birth weight and preterm infants. Where possible steroids are given to mother’s before a preterm delivery to help prevent problems associated with underdeveloped organs and lung immaturity.

Early difficulties with breathing and the need for ventilation can result in chronic lung disease (CLD), also called bronchopulmonary dysplasia (BPD), which is common in babies born preterm. CLD is a disorder that results from inflammation, injury, and scarring of the airways and the alveoli.

New research which has focused on lung problems associated with preterm birth has reported some fascinating findings. Dr. Bernard Thébaud, who is a pediatrician at the Children’s Hospital of Eastern Ontario and The Ottawa Hospital, published a paper in the medical journal Circulation reporting findings that showed that damaged lungs of preterm infants can be safely repaired using stem cells and regenerative medicine. This is the first study to demonstrate the use of vascular progenitor cells (stem cells that make blood vessels) for this purpose.

Research findings so far are based on research conducted on lab animals but the next phase of the study will begin working on opportunities for clinical trials.

These research findings have huge implications for the treatment of lung disease in preterm infants as well as the potential regeneration of other organs and other lung diseases in adult populations. This research is very important, not just for the short-term benefits but also the potential long-term benefits. For example, a lack of oxygen to other parts of the preemie infant’s body can result in other difficulties. For example, lack of oxygen can affect brain and eye development. Respiratory problems are the most common cause of death in preterm infants, although these problems have lessened over time, and they also have a large effect on other health outcomes. That is, they are related to high rates of cognitive (thinking and reasoning), motor skills, educational, and behavioural difficulties.

Research such as this could be a great step in lessening the burden and stress for families of preterm infants who often have to deal with many and varied many challenges.

Published in Industry News
Wednesday, 04 July 2012 20:42

Photo Competition Winners Announced

Congratulations to the preemiehelp photo competition winners!

Thanks too all the people that entered our Preemiehelp Photo competition.

The winners share in great prizes including, the preemiehelp ebook, “The Complete Guide to: Preemie Development.” and a Earlybirds Gift voucher (2 x $50) from Earlybirds

And the Winners are...

After much deliberation we can annouce the winners of the Preemiehelp 'preemie photo competition' .

Prizes are awarded for 3 categories

  • Life in the NICU
  • My Brave Preemie
  • Look at Me Now 

After an overwhelming responce to the competition we are happy to announce that..

In First Place

Collecting a prize of $50 Earlybirds Voucher (earlybirds.com.au) and a full set of the Preemiehelp "The preemie guide to: Surviving the NICU" & " The preemie guide to: Preemie development" is:

Angela Perry - Life in the NICU

With her winning photo - 

Photo: 1st - Angela Perry (Life in the NICU)

 

 

In Second Place

Collecting a prize of $50 Earlybirds Voucher (earlybirds.com.au) and the Preemiehelp ebook " The preemie guide to: Preemie development" is:

Andrea Creighton - My Brave Preemie

With her winning photo -

Photo: 2nd - Andrea Creighton (My brave preemie)

 

 

In Third Place

Collecting a full set of the Preemiehelp ebooks  "The preemie guide to: Surviving the NICU" & " The preemie guide to: Preemie development" is:

Ken & Lisa Young - Look at me now

With their winning photo -

Photo: 3rd - Ken & Lisa Young (Look at me now)

 

 

Published in Industry News
Saturday, 21 April 2012 13:32

Controversial: Too Small?

"I missed out on that joyful, happy moment that most people have, because I was so profoundly overcome with, she's so early."

A sentiment many parents of preemies will no doubt relate to. Every now and then, you will read articles in the news, or there might be a story on TV that discusses the issue of, “How small is too small?”

Medical and technological advances have ensured the chance of preterm babies surviving have increased significantly over the past 20 years, further still the limits of what babies at what gestational age can survive are often pushed to the extreme. Preterm babies born less than 25 weeks, sometimes called micropreemies, can invoke discussion about the moral, ethical, and financial ramifications of pushing for survival at any cost. This is true for doctors and parents themselves. For example, the question, “what level and type of care should be provided to the tiniest preterm babies?”, is often posed.

In Japan, babies born at 22 weeks are considered capable of sustaining life, in Australia, the attitude is to try an actively give the baby a chance of survival, whereas other countries advocate for “compassionate care” prior to 25 weeks gestation due to the low chance of survival. In Sweden, Norway, Finland, they don't resuscitate a baby under 25 weeks’ gestation. They say we're going to use that money for prenatal care. In the United States, babies born at 22 weeks are not resuscitated. At 25 weeks, every baby is resuscitated because more than 75% survive.

Despite the fact that medical advances improve the chance of a preterm baby surviving at younger and younger gestational ages; the stats still are not great for the tiniest of these babies, the questionable zone is usually 23 to 24 weeks; preemies born at 23 to 24 weeks have around 15-40% chance of survival but for those micropreemies who make it they also have a 30-50% chance of having a severe disability, such as cerebral palsy, intellectual impairment, blindness, deafness, or a combination of these, and a further 25-40% will have mild to moderate disabilities such as subtle forms of visual impairment, mild cerebral palsy affecting motor control, chronic asthma, learning difficulties, and behavior problems like attention deficit disorder.

Some parents of babies born at 22 weeks want everything done possible to help their baby survive, while sometimes parents of babies born at 23-24 weeks ask that nothing aggressive be done. It can be a very difficult decision for parents to make. The overwhelming portrayal of preterm babies in the media is the “miracle survival” of such tiny babies. It is rare for discussion of the potential long-term difficulties associated with such an early birth. Phyllis Dennery, chief of neonatology and newborn services at the University of Pennsylvania and Children's Hospital of Philadelphia, explains that "It's very dangerous to make this out to be a wonderful success, the reality is often quite different."

Often part of the discussion revolves around the costs involved in keeping these tiny preemie babies alive and the ongoing cost of their treatment and care. According to some estimates the average cost of care of a preterm baby in the neonatal intensive care unit (NICU) is US$4,000 to $5,000 per day. In the United States the estimated annual societal economic burden associated with preterm birth was in excess of $26.2 billion in 2005, or $51,600 per infant born preterm. For some countries such as Sweden, Norway, Finland, that don't resuscitate a baby under 25 weeks, instead advocate the use of that money for prenatal care of babies with a better chance of surviving and better chance of long-term outcomes.

A major issue is that many people don’t understand the consequences, both short- and long-term of giving birth too soon. Once a preterm baby survives many think that’s the end of it.

"We tend to think that prematurity is a problem that the minute you walk out of the nursery it's over. That's the furthest thing from the truth. More and more studies are coming out that there are long-term consequences of prematurity. If you look at lung growth, brain growth, these are all altered by the fact that you are born too early. Prematurity is with you for the rest of your life."

Published in Industry News
Monday, 07 July 2014 11:49

Preterm Birth Breakthrough: Infections

Estimates of preterm birth in Australia suggest one in 12 or approximately 8% of Australian babies is born preterm. The incidence worldwide is even higher, approximately 10%, meaning around 15 million babies are born preterm annually. The estimated cost is very high and Australia spends approximately $500 million per year on their care, whilst the United States spends more than $17 billion.

One of the causes of preterm birth is intrauterine infection or inflammation caused by infection. Experts in the field hypothesise that vaginal microorganisms break the cervical barrier, colonise the fetal membranes, and infect the amniotic cavity. The expectant mother's auto-immune response consistenting of a vigorous inflammatory reaction results in preterm birth.

An incredible breakthrough achieved at the University of Western Australia, King Edward Memorial Hospital, has described the ability of an antibiotic - solithromycin - to potentially cross the placenta and kill infections responsible for many preterm births. Professor Jeffrey Keelan estimated that up to 30% of preterm births could be prevented using this new antibiotic, solithromycin. Most of the benefits would be attributed to saving the very early prems.

The research behind this exciting breakthrough involved measurements in sheep and the crossover from sheep to human placentas is about 50% compared with only 2-4% for older antibiotics and it's 10 to 100 times stronger. Researchers report that the next step is to, confirm that in pregnant women, that the antibiotic crosses the placenta and destroys harmful bacteria. If research grants are successful clinical trials will take place between Western Australia and the United States.

This is a significant finding as currently used antibiotics are largely ineffective at destroying harmful bacteria or are unable to cross the placenta at high enough levels, thereby unable to prevent the preterm birth from occuring.

Published in Industry News
Friday, 10 May 2013 14:01

Preemies School-age

Extremely preterm babies or extremely small prems are still behind their term born counterparts in relation to intellectual, educational, and behavioral outcomes by the time they reach school-age.

A study conducted in Victoria led by the Royal Women's Hospital followed up 189 extremely preterm or extremely low birth weight babies (less than 28 weeks gestation or weighing less than 1,000g) and 173 term born children at school-age. The areas assessed were intellectual ability, spelling, reading, mathematics, and a range of behavioral outcomes.

They found that 71% of the preterm born children had a cognitive, educational, or behavioral impairment at 8 years of age. In addition, up to 47% showed multiple areas of concern. These rates are much higher than that of the term born group which was 42% and 16% respectively. The major areas of concern were reading and spelling impairment which were double the rates in preemies compared with children born full term. The researchers also reported that 15% of the prems had a significant neurosensory impairment such as cerebral palsy.

Parents also completed questionnaires about their children which revealed that the preterm group had more behavioral problems including higher rates of hyperactivity, inattention, emotional problems, and peer relationship problems.

The positive message from this research is that the majority of babies born so early and small are now surviving without major disabilities.

This research highlights the need for early identification of children likely to have difficulties and early intervention strategies need to be employed to help these children before school-age.

Published in Industry News
Sunday, 08 December 2013 15:10

Algorithm Predicts Premature Births

About three decades ago, my girlfriend came to the world as a preemie, born in the 33rd week of pregnancy. She weighed only 3.7 lbs. For the record: every birth before the 37th week of gestation is considered preterm and hence risky. There were no complications, and she grew up healthily and normally. The truth is: there is a lot that could have gone wrong. There are things the doctors didn't know in the 1980ies.

One of these things is that during the last weeks of gestation, the development of the unborn's cerebral cortex takes place. Earlier this year, resesarchers of the King's College London have published a study in PNAS that shows the effect of preterm births on the developing brain: it can cause inferior cognitive performance in infants. Visual-spatial processing, decision making and working memory might all be affected. In order to assess this, the lead author, KCL's David Edwards, investigated the growth and density of nerve cells using diffusion MRI (dMRI).

Moreover, there are strong indications preterm births are a risk factor for sudden infant death, autism, ADHD and cerebral palsy. The CDC names preterm births as a risk factor for cerebral palsy, too. Breaking Bad co-star RJ Mitte suffers from a mild form of cerebral palsy. It remains unclear, though, whether his condition was caused by preterm birth or not. A recent study suggests that also exposition to phthalates (contained in food, industry and hygiene products) are one of the causes for preterm deliveries.

But hope is underway. In a recent study published in PLOS ONE, computer scientist Paul Fergus and his team of researchers have found a way to predict preterm births using machine learning and the right data. They obtained the data by harnessing electrohysterography (EHG), that is measurng electrical signals of uterine activity. This method has been used before to measure the contractions during labour.

What Fergus' algorithm does is classify the recorded signals into term and preterm signals. The trick is to measure the uterine signals early on. The paper states that "distinct contraction-related, electrical uterine activity is present early on in pregnancy, even when a woman is not in true labour." The amount of these signals increases steadily during the pregnancy and shoots up during the last three to four days.

The new method is still prone to errors and produces results of varying quality, depending on the underlying data. The number of examined records suggests Fergus was not exactly using big data. 300 records of which only 38 were preterm records. Fergus himself states in the conclusion of his paper, that the low number of preterm records didn't allow the machine learning classifiers to learn properly. Even though, the concept works and seems promising. Once all errors have been eliminated, the technique could predict a "Yes" or "No" to answer the question "Will my child be born on term?" The resarchers suggest to further improve the quality of the algorithm's outcome in the future: The answer could then be how many weeks remain until the birth.

Published in Industry News

The Victorian Brain Infants Studies (VIBeS) began a very important research project in January 2005, which aimed to establish if receiving developmental care at home was more beneficial than the current standard care, the study is known as the VIBeS Plus program.

There are around 3,000 very low birth weight (less than 1500 grams) or very preterm infants (less than 30 weeks gestational age) born each year in Australia. Survival rates for these very preterm infants have improved dramatically in the last few decades to be greater than 85%, however a significant proportion of children experience movement, behavioural or social problems which have life-long consequences. Early intervention programs, such as the VIBeS Plus program may reduce these risks. To date, the success of these programs has not been fully established.

The original VIBeS Plus study was a randomised control trial of a preventative care intervention. There were 120 families who participated and were randomised to either the “intervention group” or “control group”. The intervention designed by the Victorian Infant Brain Studies (VIBeS) team, consisted of 9 visits over the first year of life, conducted by 2 teams comprising a psychologist and a physiotherapist who were specially trained to deliver the intervention program. The intervention aimed to educate the primary caregivers about infant self-regulation and techniques for improving postural stability, coordination, and strength and to support the parents’ mental health and parent infant relationship throughout the first year. Each session lasted ~1.5 to 2.0 hours and was conducted in the family home, with a few exceptions in which the infants were seen in the hospital. Both groups were offered an MRI scan of their infant's brain at term corrected age.

Many of the neurobehavioral impairments described in preterm children persist into adolescence and adulthood. Further, caregivers of very preterm survivors experience high rates of mental health problems. Studies examining the effectiveness of early developmental intervention programs designed to reduce the burden of developmental problems report short-term benefits for infants and their caregivers.

VIBeS Plus previously demonstrated that at 2 years the early preventive care program improved preterm infants’ behavioural outcomes and reduced primary caregivers’ anxiety and depression. The follow-up study conducted at age 4 years showed that home-based preventive care over the first year had selective long-term benefits. There were meaningful differences in the thinking and learning, language and motor scores between treatment groups. Also, children in the intervention group showed less attention problems, such as ADHD, and behavior difficulties as well as increased competence compared with the controls.

Given the important role of parenting on child development, it is possible that the full benefits of this preventive care program will not be observed until later in development. Thus it is vital to determine whether early preventative care programs have long-term benefits beyond early development and preschool years. VIBeS Plus are currently following up this group of preterm children at school-age. Follow-up at school age is ideal for assessing the usefulness of this program, as this is when brain development and social maturation are relatively stable, and when the social demands of the environment (primary school) are also relatively consistent.

Published in Industry News
Monday, 10 December 2012 17:45

L’il Aussie Prems Foundation

L’il Aussie Prems Foundation is Australia’s largest online support community and forum for families of prematurely born children and sick newborns. They are a voluntary not-for-profit organisation set up to provide online support, raise awareness, bring parents together who have traveled a similar path whilst encouraging families to share their personal and unique journey through our website. No matter where families are located geographically, our website and support services are assessable 24 hours a day, 7 days a week.

The Foundation’s website was initially established in 2007 by a premmie mum who gave birth to her first son at 27 weeks gestation. The forum and website continue to offer a lifeline to families. In October 2012, with the goal of expanding the online support provided to families, L’il Aussie Prems Foundation became a registered charity, incorporated in the state of Victoria.

The Foundations committee members are all parents who have each experienced a very personal and unique journey after the premature birth of their children. As members of the forum community for many years, they each understand the vulnerability parents feel in a similar situation, the importance of an online community and the integral role the Foundation plays with offering a safe and supportive environment to each family.

Published in Industry News
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
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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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New Release - Preemie Development

All in one easy to read eguide

‘The complete preemie guide to: ‘Preemie development’ is the must have guide to the NICU for new preemie parents.

With an easy-to-read layout this comprehensive guide is over 130 pages of important information about the NICU and your preemie.

Using Adobe’s .pdf format makes the guide usable across a wide range of platforms from ipad to PC, smartphone to macbook.

Packed with extra features like progress charts, NICU checklists and plenty of others. ‘The preemie guide’ is a must for any new parents.


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