Low Birth Weight Preterm Children Research Articles

Supporting cognitive catch-up: The effects of cluster-randomized psychosocial stimulation interventions on preterm low birthweight children in rural China.

Improved survival of preterm low birthweight (LBW) infants due to advances in neonatal care has brought issues such as postnatal development trajectories to the foreground. This study pools evidence from three cluster-randomized experiments evaluating community-based psychosocial stimulation programs conducted from 2014 to 2017 that included 3571 rural Chinese children aged 6-24 months (51.1% male, 96.2% Han Chinese). The risk of severe cognitive delay was found to be 26.5 percentage points higher for preterm LBW children than for their peers at age 2.5, with a prevalence rate of 48.3%. Results show that psychosocial stimulation interventions can improve child cognitive development at scale, with beneficial impacts on child cognition disproportionately larger for preterm LBW children, helping them to catch up developmentally.

Growth patterns of urban Malaysian children under 24 months of age in Selangor, Malaysia

Introduction: To identify the growth patterns of young children during the first two years of life according to gestational age, birth weight, and growth status at 24 months of age. Methods: This was a retrospective cohort study of 4,570 young children in Selangor. Data were extracted from children’s health records in government health clinics. Growth data were analysed using the Anthro Plus software that utilises the World Health Organization growth standards. Results: Generally, wasting prevalence was the highest at birth and 24 months, but stunting was more predominant from 1 to 21 months. Weight-for-age z-scores (WAZ), lengthfor-age z-scores (LAZ), and weight-for-length z-scores (WLZ) from birth to 24 months were within -3.00 to 0.00 standard deviation (SD) for pre-term low birth weight children, –1.50 to 0.00 SD for pre-term normal birth weight children, and –2.50 to 0.50 SD for full-term low birth weight children. While WAZ, LAZ, and WLZ from birth to 24 months for underweight/stunted/wasted children were within –2.50 to 0.50 SD, the values for overweight/obese (OV/OB) children were within –1.00 to 2.00 SD. For normal children, WAZ, LAZ, and WLZ exhibited comparable trends, with values within –1.00 to 0.00 SD from birth to 24 months. Conclusion: While stunting and wasting persisted as the most common forms of malnutrition in this sample of young children, the prevalence of OV/OB increased by 24 months. Interventions to promote child growth should focus not only on the prevention of undernutrition, but also on OV/OB.

Hypomineralized Primary Teeth in Preterm Low Birth Weight Children and Its Association with Molar Incisor Hypomineralization-A 3-Year-Prospective Study.

The present prospective study was conducted to assess the prevalence of enamel hypomineralization (EH) in primary dentition among preterm low birth weight (PT-LBW) children, incidence of molar incisor hypomineralization (MIH) in the same cohorts, and to determine associations between PT-LBW, hypomineralization in primary second molars, and MIH. A total of 287 PTLBW study subjects and 290 control full-term normal birth weight subjects were followed up for 36 months. Enamel defects were recorded at baseline. The same cohorts were examined after 3 years for MIH using the European Academy of Paediatric Dentistry (EAPD) criteria. Multiple variable logistic regression models were developed. A total of 279 children (48.4%) presented with EH in primary dentition and 207 (35.9%) children presented with MIH. Children with primary second molar hypomineralization had 2.13 (R2 = 0.19, 95% CI = 0.98–4.19, p = 0.005) times higher frequency of MIH. Children with PT-LBW had 3.02 times (R2 = 0.31, 95% CI = 1.01–5.94, p = 0.005) higher frequency of MIH incidence after adjusting for childhood infection, prenatal history, and presence of hypomineralized primary second molars. To conclude, the present study showed significant association between PT-LBW, hypomineralized second primary molars, and incidence of MIH.

Real world research on the growth pattern of preterm children with different birth weight

Objective: To investigate the physical indices and growth status of preterm children aged 0 to 4 years with different birth weight. Methods: Following the real world research approach, the current study retrospectively collected e-chart information of 8 496 preterm children from the child health care system of the Children's Hospital of Chongqing Medical University from December 2010 to December 2017, with 203 123 full-term children followed up during the same period as controls. Premature children were divided into normal birth weight (NBW) group, low birth weight (LBW) group, and very low birth weight (VLBW) group based on their birth weights. The weight and length development within 48 months of age of preterm boys and girls in each group were measured and recorded to establish a numerical table and analyze the growth levels, growth rate, and proportionality. The t-test or chi-square test was used for between-group comparison. Results: Of the 8 496 preterm children, 4 839 were girls and 3 657 boys, including 525 in the VLBW group, with an average birth weight of (1.28±0.14) kg, 3 862 in the LBW group, with an average birth weight of (2.07±0.28) kg, and 4 109 in the NBW group, with an average birth weight of (2.86±0.35) kg. The weight at the actual age of 2-<3 months ((5.61±0.96) vs. (5.64±0.78) kg in boys, (5.11±0.67) vs. (5.18±0.71) kg in girls) and the length at the actual age of 8-<10 months ((70.3±2.4) vs. (70.6±2.4) cm in boys, (68.9±2.2) vs. (68.9±2.4) cm in girls) in the NBW group reached the average weight and length of full-term children. The difference of physical growth before 24 months of age between LBW and control group decreased as children age, with that of LBW group approaches the average of full-term children after 24 months of age, with a weight difference of 0.64-0.95 kg and height difference of 1.3-1.7 cm. The weight and height of the VLBW group were lower than those of full-term infants (2.80-2.86 kg and 3.3-4.3 cm, respectively) at 48 months of age. During 2-12 months of age, the corresponding values of the VLBW group were higher than that of the LBW and NBW groups by 0.35 kg and 0.71 kg, respectively. However, the corresponding values of the VLBW group were lower than that of the LBW and NBW groups(0.64 kg and 0.76 kg at 0-2 months of age, 1.04 kg and 1.49 kg at 12-48 months of age, respectively). The rates of delayed development, underweight, and emaciation were the highest in the VLBW group (all P<0.01), while the rates of overweight and obesity were the highest in the NBW group, with that of the VLBW group being lower than LBW group (P<0.01) at the age of 24-<36 months. Conclusions: Prior to 4 years of age, the time for preterm children to reach the average physical indices of full-term children differ by birth weights, hence warranting further examination of the corrected gestational age for preterm children. Normal birth weight preterm children present with the highest incidence of overweight and obesity and very low birth weight preterm children present with the highest incidence of growth disorders, marking both groups at high risks of malnutrition.

Very Low Birth Weight Preterm Children Motor Performance in the First Year of Life

AbstractMotor skills acquisition is negatively affected by low birth weight in preterm infants. This research aimed to evaluate the motor development of preterm babies from zero to 12 months of corrected age, born with very low birth weight. The sample of 45 children, from 2 to 12 months of chronological age, was divided into two groups: Group A (from 0 to 6 months, n=35) and Group B (from 7 to 12 months, n=10). In order to assess the motor skill development, Alberta Infant Motor Scale (AIMS) was used along with two questionnaires to control the biological and environmental risk factors. In the results 53,3% of the children were preterm below 30 weeks gestational age, and more than 40% of the evaluated population presented a poor motor performance for the age, with 13.3% of the referred children as having abnormal motor development and 35.6%, suspicious of delayed motor development. The worst performance could be observed in Group B. The findings reinforce the importance of early assessment, considering that the first semester is the most critical period for the child’s neuropsychomotor development. Key-words: Infant, Premature. Motor Skills. Infant, Very Low Birth Weight. &#x0D; Resumo O baixo peso ao nascer afeta negativamente as aquisições motoras dos prematuros. Esta pesquisa teve como objetivo avaliar o desenvolvimento motor de bebês pré-termos de zero a 12 meses de idade corrigida, nascidos de muito baixo peso. Participaram da pesquisa 45 crianças, com idade entre 2 e 12 meses de idade cronológica, divididas em 2 grupos: Grupo A (0 a 6 meses, n=35) e grupo B (7 a 12 meses, n=10). Para avaliação motora foi utilizada a Alberta Infant Motor Scale (AIMS) e dois questionários para controle dos fatores de risco biológicos e ambientais. Nos resultados, 53,3% das crianças eram prematuras com idade gestacional menor que 30 semanas e mais de 40% da população avaliada apresentou desempenho motor inadequado, sendo que 13,3% apresentaram atraso e 35,6% suspeita de atraso. O pior desempenho foi observado no grupo A. Os achados reforçam a importância da avaliação precoce, considerando que o primeiro semestre é o período mais crítico ao desenvolvimento motor. &#x0D; Palavras-chave: Recém-Nascido Prematuro. Destreza Motora. Recém-Nascido de muito Baixo Peso.

Patterns and prediction of behavior problems during the toddler and preschool periods in preterm children

There are few studies of behavior problems in preterm children prior to 2 years old and the changes that occur over time. The aims of this study were to examine the patterns and prediction of behavior problems and the effects of gender and socioeconomic status (SES) on behavior problems in preterm children at the toddler and preschool periods. Parents of 124 very low birthweight preterm children completed a standardized behavior questionnaire at 18 months corrected age and 3 years old. At both times, scores were significantly higher on Attention and Withdrawn Problems than on other behavior problem syndromes. There was a significant overall increase in Externalizing and Internalizing behavior problem scores between 18 months and 3 years, particularly in Internalizing problems. Overall prediction for normal versus not-normal categorization (≥1 standard deviation) on behavior problem and broad-spectrum scales ranged from 77% to 90% and was higher for children in the normal than not-normal categories. Boys had higher Internalizing Problems at 18 months and higher Externalizing Problems at 3 years. Children from low SES families had higher Internalizing and Total Behavior problems at 18 months and higher Internalizing, Externalizing, and Total Behavior problems at 3 years. Screening preterm children for behavior problems before 2 years old appears useful for early intervention of such problems.

The association between perinatal and neonatal variables and neuropsychological development in very and extremely low-birth-weight preterm children at the beginning of primary school

Preterm children with very low birth weight (<1,500 g) and extremely low birth weight (<1,000 g) have an increased risk of experiencing neuropsychological delays. The purpose of this study is to characterize the neuropsychological profile of very and extremely low birth weight preterm children and discover what maternal conditions, diseases, procedures, and alterations in preterm newborns could be related to their later neuropsychological development. Eighty-nine preterm children (aged from 5 to 7 years) were assessed on their intelligence quotient (IQ), executive function, memory, and visuospatial memory in a single session, using the RIST and NEPSY-II test. Parents provided sociodemographic data. Preterm children showed lower scores than normative values on impulsivity, visual short-term memory, and spatial relation abilities. Extremely-low-birth weight preterm children also showed less inhibitory control and worse mental rotation skills. Neonatal surgical procedures, late-onset sepsis, and periventricular hemorrhages had the greatest impact on neurodevelopment. When one or more of these conditions are present, memory is the most affected neuropsychological function, followed by visuospatial skills, inhibitory control, and IQ. It is important to take into account the presence of maternal conditions, diseases, interventions, and neonatal alterations in preterm newborns in order to determine the risk of neuropsychological delays in later development.

Preliminary study of urinary arsenic concentration and arsenic methylation capacity effects on neurodevelopment in very low birth weight preterm children under 24 months of corrected age.

The neurological prognoses of very low birth weight preterm (VLBWP) children during the first 2 years of life will influence their neurodevelopment during subsequent childhood years and adolescence. The objective of this study was to systemic investigate relationships of urinary arsenic (As) concentrations, the As methylation capability, and toenail As concentrations on cognitive, language, and motor development in VLBWP children under 24 months of corrected age.Participants (n = 60) in our study were recruited from October 2010 to April 2013. Urine and toenail samples were collected for evaluation to assess As exposure. The Bayley scales of infant development III were used to evaluate neurodevelopment at 2 years of corrected age. Concentrations of As species in urine and the As concentration in toenails were, respectively, analyzed using HPLC-HG-AAS and ICP-MS.The mean concentration of total As was 28.6 μg/g creatinine, and inorganic As was 1.01 μg/L in urine. The urine contained an average of 3% inorganic As, 2% monomethylarsonic acid, and 95% dimethylarsinic acid (DMA). The mean concentration of As in toenails was 225 ng/g. Children with a longer gestational age (≥28 weeks) and higher DMA % levels appeared to have the highest unadjusted cognitive and fine motor scores.Our study results suggest that gestational age is associated with neurodevelopment in VLBWP children. We recommend that further study simultaneously analyze multiple environmental contaminants that may have adverse effects on neurodevelopment, use biomarkers for the mother–child pair, and determine whether prenatal or postnatal As exposure has a greater influence on the neurological development of VLBWP children.

Follow-up study of extremely low birth weight preterm infants to preschool age in the light of perinatal complications

Owing to the rapid progress of the medical science and technology, the chances of survival of the extremely low birth weight (<1000 g) preterm babies have dramatically improved. Nevertheless, the research findings on their long-term developmental outcome are inconsistent. Our study has attempted to contribute to the understanding of the developmental mechanisms in the extremely low birth weight preterm infants and to the prediction of the developmental outcomes taking into account of the risk factors of development. 34 preterm children who were free of any major central nervous system injury were followed up from one to 5-6 years of age. The psychomotor development of the infants was assessed at 1 and 2 years of age and, at 5-6 years of age, intelligence tests were administered to the children. Perinatal and environmental factors were included in the data analysis. The extremely low birth weight preterm children as a group displayed no developmental delay at any of the measurement points. The mean developmental quotients were 98.6 and 106.6 at ages 1 and 2 years, respectively. At 5-6 years of age, the mean verbal IQ was 101.4, while the mean performance IQ was 92.9. Behind the group means there was a wide range of individual variations. The most powerful contributors to the developmental outcomes were birth weight, bronchopulmonary dysplasia, intra-uterine growth retardation, gender, and maternal education. The girls had a significant advantage over the boys in language development. Verbal intelligence was hampered by intracranial hemorrhage, while intrauterine growth restriction had a similar effect on the performance IQ. Our results suggest that even the extremely preterm infants may have rather good chances of satisfactory mental development. However, the individual developmental prospects are influenced by a great number of domain-specific risk- and protective factors. Although at a group-level, infant psychomotor development is a significant predictor of later intelligence quotient, the rate of development may change at any age. The phenomenon of "moving risk" underscores the importance of the long-term follow-up of preterm infants. Orv Hetil. 2018; 159(41): 1672-1679.

Hand function and its prognostic factors of very low birth weight preterm children up to a corrected age of 24 months

A delay in functional hand performance broadly affects a child's successful participation in daily activities as well as later academic performance. Despite its high prevalence, hand function has received much less attention than other developmental domains, especially for young children. The aims of this study, therefore, were to examine hand function in preterm children up to a corrected age of 24 months; to establish predictive models for estimating preterm children's hand function; and to identify the contribution of early neuromotor assessments. This study included 230 preterm children (69, 76, and 85 children at corrected ages of 6-, 12-, and 24-months, respectively) who were recruited from the database of the preemie follow-up clinic at the National Cheng Kung University Hospital in Tainan, Taiwan. Hand function was evaluated using the Peabody Developmental Motor Scales II. Demographic information, birth history, and developmental documents were obtained from the medical records of routine preemie clinic follow-ups. Approximately half of healthy preterm children demonstrate hand function deficits at 12 and 24 months of corrected age. The Neonatal Medical Index, representing an infant's history of medical complication, was the best predictor of hand function at 12 and 24 months of corrected age. The social factor, represented by maternal educational year, was found to have influence on hand function only in preterm children at corrected age of 24 months old. Finally, early neuromotor performance demonstrated significant predictability of later hand function that supports the importance of continuous follow-up examinations in children with a history of prematurity. An understanding of a preterm child's early hand function as well as how its risk factors evolve helps clinicians both target children who might benefit from early intervention and ensure that children reach their full developmental potential.

Cognition, behavior and social competence of preterm low birth weight children at school age

OBJECTIVE:The aim of this study was to assess the cognitive and behavioral development of preterm and low birth weight newborns living in a disadvantageous socioeconomic environment at school age. METHODS:This cross-sectional study included children aged 6-7 from a historical birth cohort of preterm (gestational age <37 weeks) and low birth weight (<2,500 g) infants. The Wechsler Intelligence Scale for Children III (WISC-III) was administered by a psychologist while the parents completed the Child Behavior Checklist. The results were compared to the test's reference. The perinatal information and follow-up data were collected from the hospital files. The demographic data were collected from the parents. The current performance was compared with the results from the Denver II and Bayley II tests, which were administered during the first years of life.RESULTS:The total intelligence quotient varied from 70 to 140 (mean 98.7±15.8). The borderline intelligence quotient was observed in 9.3% of the children. The Child Behavior Checklist indicated a predominance of social competence problems (27.8%, CI 19.2 to 37.9) compared with behavioral problems (15.5%, CI 8.9 to 24.2). Both the Child Behavior Checklist domains, such as schooling, social and attention problems, and the cognitive scores were significantly associated with maternal education and family income. The results of the Denver and Bayley tests were associated with the cognitive performance (p<0.001) and the Child Behavior Checklist social profile, including aggressive and externalizing behavior (p<0.001).CONCLUSIONS:Our data suggest that even low-risk preterm newborns are at risk for developing disturbances in early school age, such as mild cognitive deficits and behavioral disorders. This risk might increase under unfavorable socioeconomic conditions.

Awareness of Dental Treatment Protocol for Pregnant Women and Lactating Mother’s in General Dental Practitioners of Davangere District, Karnataka, India

Dear editor, Oral health is vital for successful pregnancy and lactation. Physiological changes in pregnancy cause several systemic and local physical changes. Alterations in the mother’s health and medical and dental interventions during pregnancy and lactation influence on growth of the foetal and infant. Many dentists are reluctant to provide dental care to pregnant patients and lactating mothers due to the risks involved. These apprehensions can cause inadequate oral care in Davangere population. The questionnaire-based Survey was conducted to assess–awareness of established treatment protocols of treating pregnant women and lactating mothers among dentists in this population. Second trimester is the safe trimester for dental treatment, [1] elective dental treatment like restoration, replacement of the missing teeth and extractions are to be performed in this trimester [2]. Eighty-Eight percent of the dentists had the knowledge about safe trimester and Fifty-Six percent of dentists followed this protocol for restoration, Fifty-Four percent for extraction and Forty-Four percent follow this protocol for teeth replacement. First and third trimesters are not safe because in first trimester major organs are being formed and would be at risk. During the 3rd trimester it is uncomfortable for mother to lie back in a dental chair for a long period and stress in this period may result in premature delivery [1]. Left lateral supine position is the ideal position for treating pregnant women [3], only Fifty-Six percent practitioners treated their patients in this position. Right lateral supine position causes pressure in aorta and inferior vena cava resulting in reduced cardiac output and supine hypotension, to the mother. Dental radiographs can be taken during all the trimesters of pregnancy if standard radiation hygiene practices like use of lead apron and thyroid collar are followed [4]. Twenty-Four percent practitioners followed the protocol. Dental radiography is limited to oral and maxillofacial region, additionally use of high speed films, filtration and collimation greatly reduce radiation exposure and exposure time. The 1st trimester is the period of organogenesis; hence use of diagnostic radiography should be minimized, in this period. Gingival bleeding and calculus deposit should be managed by oral hygiene instructions, prescribing mouth rinses and scaling. Fifty percent of the dentists followed this procedure. Failure to treat these patients appropriately places them at a risk of having preterm low birth weight children [5]. Preferred analgesic of choice for pregnant women is paracetamol and for lactating mother, paracetamol and ibuprofen [2]. Most of the practitioners followed this protocol and rest of the practitioners prescribed contraindicated drugs like aspirin and codeine. Amoxicillin, cephalosporin and Clindamycin are antibiotics of choice during pregnancy and lactation [2]. Ten percent of dentists treating pregnant women and Twelve percent of dentists treating lactating mothers prescribed antibiotics as per case requirement, irrespective of contraindications in this patient population. Choice of local anaesthesia for pregnant women and lactating mothers is lidocaine with adrenaline [6]. Forty percent dentists treating pregnant women and Fifty-Six percent treating lactating mothers used lidocaine with adrenaline while rest of the practitioners avoided adrenaline. Avoidance of adrenaline would shorten the duration of action which will limit the time available for dental procedure, and induce dental pain/psychological stress [6]. This survey showed that there is a clear lack of knowledge about appropriate management of the pregnant women and lactating mothers, necessitating continuous dental education and dental curricular on the management of the pregnant women and lactating mothers for undergraduate and post graduate.

Children born small for gestational age are not at special risk for preschool emotion and behaviour problems

Despite the wealth of literature examining long term outcomes of preterm low birthweight children, few studies have directly assessed the developmental impact of being born full term but small for gestational age (SGA). We aim to determine whether (i) being SGA increases preschool behavioural problems and (ii) other risk factors operate differently in SGA and appropriate for gestational age (AGA) controls. 550 New Zealand European mothers and their 3.5year old children participated in this study. All children were born at full term (>37weeks' gestation) and approximately half were SGA (≤sex specific 10th percentile for gestation) the remainder were AGA controls. Extensive data were collected at the child's birth, 1year and 3.5years. Behavioural problems were measured when children were 3.5years, using the Strengths and Difficulties Questionnaire (SDQ). Multiple regression analyses were used to examine the associations between risk factors and behavioural problems; statistical weighting was used for analyses of the total study group. There was no significant difference in behavioural problems between SGA and AGA groups. In the total sample the significant predictors of behavioural problems included: mothers' school leaving age; smoking during pregnancy; maternal alcohol use during pregnancy; and absence of the father. Predictors of behavioural problems were found to be the same for SGA and AGA groups. These results do not support the view that SGA is a risk for behavioural preschool difficulties or that SGA children are sensitised to risks known to be associated with such difficulties in the preschool years.

Evolution of obesity in a low birth weight cohort

The objective of this study was to determine the evolution of obesity status (OS) in a longitudinal cohort of low birth weight preterm (LBWPT) infants to an age of 8 years, and to determine whether rapid weight gain in the first year of life independently predicts 8-year OS. In total, 985 infants (birth weight ≤2500 g, gestation age ≤37 weeks) were recruited from the nursery in an eight-site intervention research program and were evaluated at an age of 3, 5, 6.5 and 8 years. Weight and height were measured by standard protocol at each visit and body mass index was calculated. Obesity status is ≥95% for age and sex. Multiple logistic analyses were performed on 8-year OS with predictor variables including infant race, gender, small for gestational age status, birth weight category, neonatal health index, treatment group and first-year weight gain; maternal education and weight status before conception; and HOME Inventory. Overall, 2.3% were OS at an age of 3 years, 6.1% at an age of 5 years, 7.7% at age 6.5 years and 8.7% at an age 8 years. OS varied by birth weight category at each visit. The infants born ≤1500 g had the lowest prevalence of OS at each age. In the logistic regression, maternal race (Hispanic) (adjusted odds ratio=2.8, confidence interval=1.2 to 6.8), maternal obese status (adjusted odds ratio 3.4, confidence interval=1.5 to 7.8) and first-year weight gain (adjusted odds ratio=2.7, confidence interval=1.9 to 3.9), significantly predicted 8-year OS. OS is common in LBWPT infants during childhood, and prevalence varies by birth weight category. High weight gain in the first year of life is an important predictor of the development of OS in LBWPT children.

Neuropsychological and behavioral effects of postnatal dexamethasone in extremely low birth weight preterm children at early school age

To study postnatal dexamethasone treatment effects on cognitive, neuropsychological and behavioral functioning at early school age in preterm children. We recruited 222 children born between 1998 and 2003: 114 extremely low birth weight (<1000 g; 60 dexamethasone-treated; 54 untreated) and 108 term-born. Data were analyzed using multivariate methods. Preterm performed below term-born on all measures. Dexamethasone-treated performed below dexamethasone-untreated in immediate visual memory, visual-motor integration, mathematical skill and motor dexterity. However, stepwise regression indicated that medical and sociodemographic factors other than dexamethasone contributed to preterm group differences. Dexamethasone alone does not explain neurocognitive impairment in preterm children. Medical and sociodemographic factors (illness severity, male gender and parental education) are influential. Prospective longitudinal neuropsychological and behavioral study from preschool to school age that considers medical and sociodemographic variables will best address effects of dexamethasone exposure.

Are former late-preterm children at risk for child vulnerability and overprotection?

BackgroundParent perception of child vulnerability (PPCV) and parent overprotection (POP) are believed to have serious implications for age appropriate cognitive and psychosocial development in very low birth weight preterm children. AimWith recent concerns about suboptimal developmental outcomes in late-preterm children, this study was aimed at examining the relationship between history of late-preterm birth (34-36 6/7weeks gestation), and PPCV, POP, and healthcare utilization (HCU). Study designThis was a cross-sectional observational design. ParticipantsStudy participants were mothers of 54 healthy singleton children recruited from community centers including Women and Children Clinics (WIC), primary care clinics and daycare centers in the upper Midwest region. Outcome measuresOutcome measures included Forsyth Child Vulnerability Scale (CVS), Thomasgard Parent Protection Scale (PPS) scores, and healthcare utilization (HCU). Potential covariates included history of life-threatening illness, child and maternal demographics, and maternal stress and depression using the Center for Epidemiologic Studies Depression Scale (CESD). ResultsHCU (p=0.02) and the PPS subscales of supervision (p=0.003) and separation (p=0.03) were significant predictors of PPCV in mothers of 3–8years old children with late-preterm history. Age of the child (p=0.008) and CVS scores (p=0.005) were significant predictors of POP. Maternal age (p=0.04), stress (p=0.04), and CVS scores (p=0.003) were significant predictors of HCU. Dependence, a subscale of the PPS, correlated with the child's age and gender even after controlling for age. ConclusionHistory of late-preterm did not predict MPCV, MOP, or HCU in healthy children. Future research is needed in larger more diverse samples to better understand causal relationships and develop strategies to lessen risks of MPCV and MOP.

Histopathological characteristics of primary teeth in pre-term very low birth-weight child: Case report

Several studies have reported that the prevalence of enamel hypoplasia in pre-term low birth-weight children is higher than that in normal birth-weight children. However, the features of primary teeth dentin in pre-term low birth-weight children are rarely reported. We clinically examined a pre-term very low birth-weight child, and performed histopathological examinations of the extracted primary incisors. Hypomineralized enamel was observed in the permanent upper central incisors, while enamel defects were not detected in primary teeth. In the histopathological examinations, several features of dentin defects, such as irregular dentinal tubules and globular dentin, were observed on the pulpal side of dentin. These findings indicated that dentin formation in the present low birth-weight children was mainly affected during the natal and postnatal periods. Our results provide the evidence that tooth formation in low birth-weight children is affected by postnatal systemic derangement.

Cognitive and behavioral status of low birth weight preterm children raised in a developing country at preschool age

To assess cognitive and behavioral development at preschool age of children born preterm and with low birth weight and raised in a developing country. Prospective cross-sectional study of 80 neonates born in a university hospital in southern Brazil. Neuropsychological assessment at age 4-5 years included the Wechsler Preschool and Primary Scale of Intelligence (WPPSI), Conners' Parent Rating Scale-Revised, Denver test and neurological examination. Perinatal and early neuropsychomotor development information was collected from the database during follow-up. Results were related to birth weight, sex and gestational age. WPPSI scores were: total intelligence quotient (IQ) 88.00+/-16.96, verbal IQ 89.72+/-16.72, and executive IQ 88.12+/-15.71 for the group with less than 1,500 grams; and total IQ 91.11+/-14.73, verbal IQ 93.36+/-12.65, and executive IQ 90.20+/-16.06 for the group between 1,500 and 2,500 grams. The best scores were obtained in tests that evaluated capacity of abstraction and symbolization, picture completion and common perception, in which only 5% and 6.3% of the children had abnormal results, respectively. The lowest scores were obtained in tests that evaluated visual-motor coordination and flexibility-speed of reasoning, in which 27.5% and 16.3% of the children had abnormal results, respectively. A total of 32.5% had abnormal results in the arithmetic tests. Behaviors related to attention deficit/hyperactivity disorder (ADHD) were observed in 48% of the sample. Low score in the Bayley Mental Scale and abnormal result in the Denver test were significantly correlated to ADHD (p = 0.017 and p = 0.004). Abnormal results in the Bayley Mental Scale (p < 0.001), Denver test (p < 0.001) and neurological examination (p = 0.002) were associated with lower IQ. The results revealed an increased incidence of behavioral and cognitive disorders at preschool age.

As low birth weight babies grow, can well-educated parents buffer this adverse factor? A research note

This research note combines two national Taiwanese data sets to investigate the relationships among low birth weight (LBW) babies, their parents' educational levels, and their future academic outcomes. We find that LBW is negatively correlated with the probability of such children attending college at age 18; however, when both parents are college or high school graduates, such negative effects may be partially offset. We also show that discrimination against daughters occurs, but only for daughters who were LBW babies. Moreover high parental education can buffer the LBW shock only among moderately LBW children (as compared with very LBW children) and full-term LBW children (as compared with preterm LBW children).

Internal Capsule Abnormalities on Neonatal Brain Mri are Associated with Later Gait Disorders in Very Low Birth Weight Preterm Children at 4 Years

Internal Capsule Abnormalities on Neonatal Brain Mri are Associated with Later Gait Disorders in Very Low Birth Weight Preterm Children at 4 Years