Premature Children Research Articles

Impact of Executive Functions and Parental Anxiety on the Development of Social Cognition in Premature Children: A Cross-Sectional Case-Control Protocol.

Background: Recent research has identified neuropsychological disorders, specifically executive function disorders, in premature children. Executive functions support goal-oriented mental activity and play a role in the development of social cognition. This underlies the social and emotional behavior of individuals. Parental anxiety is also an important environmental factor that can influence the psycho-emotional development of children.Objectives: The present protocol aims to compare the development of social cognition in school-age children born prematurely to that of school-age children born full-term, and to determine the impact of executive (dys)function and parental anxiety on such development.Methods/Design: In this cross-sectional protocol, 28 prematurely born children aged 7-10 years (“preterm”) and 28 full-term born children aged 7-10 years (“control”) will be included. The “preterm” and “control” groups will be matched for sex and age. The neuropsychological evaluation will include that of non-verbal intellectual efficiency (Raven's colored progressive matrices), verbal level (WISC-IV subtests), and executive functions (NEPSY II subtests and the opposite worlds of TEA-CH). The evaluation of social cognition will be conducted via tests of the theory of cognitive and affective mind. Several dimensions of the level of parental anxiety will be collected through the Spielberg Trait Anxiety Inventory Form Y, Beck Depression Inventory, Social Support Questionnaire-6, Parental Stress Index and, specifically for mothers, the Modified Perinatal Post-Traumatic Stress Disorder Questionnaire.Discussion: The results of this protocol will aid our understanding of the development of social cognition in premature children and to determine the factors that influence such development. This clinical research project, although following a fundamental approach, will have clinical implications because a more precise description of the development of social cognition in this school-age population will make it possible to better determine the cognitive targets of therapeutic actions and to search for predictive indices of the efficacy of practices.Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03007095, identifier: NCT03007095.

Endogenous erythropoietin at birth is associated with neurodevelopmental morbidity in early childhood

BackgroundNew biomarkers that predict later neurodevelopmental morbidity are needed. This study evaluated the associations between umbilical cord serum erythropoietin (us-EPO) and neurodevelopmental morbidity by the age of 2–6.5 years in a Finnish cohort.MethodsThis study included 878 non-anomalous children born alive in 2012 to 2016 in Helsinki University Hospitals and whose us-EPO concentration was determined at birth. Data of these children were linked to data from the Finnish Medical Birth Register and the Finnish Hospital Discharge Register. Neurodevelopmental morbidity included cerebral palsy, epilepsy, intellectual disability, autism spectrum disorder, sensorineural defects, and minor neurodevelopmental disorders.ResultsIn the cohort including both term and preterm children, us-EPO levels correlated with gestational age (r = 0.526) and were lower in premature children. High us-EPO levels (>100 IU/l) were associated with an increased risk of severe neurodevelopmental morbidity (OR: 4.87; 95% CI: 1.05–22.58) when adjusted for the gestational age. The distribution of us-EPO levels did not differ in children with or without the later neurodevelopmental diagnosis.ConclusionsAlthough high us-EPO concentration at birth was associated with an increased risk of neurodevelopmental morbidity in early childhood, the role of us-EPO determination in clinical use appears to be minor.ImpactWe determined whether endogenous umbilical cord serum erythropoietin would be a new useful biomarker to predict the risk of neurodevelopmental morbidity.This study evaluated the role of endogenous erythropoietin at birth in neurodevelopmental morbidity with a study population of good size and specific diagnoses based on data from high-quality registers.Although high umbilical cord serum erythropoietin concentration at birth was associated with an increased risk of neurodevelopmental morbidity in early childhood, the clinical value of erythropoietin determination appears to be minor.

Pattern of growth development of premature children at the age of two and three years in Alexandria, Egypt [Part II

Thisis the second part of a paper on a study conducted in Alexandria on 68 premature children. Controls were full-term children, double the number of prematures, and matched by age and sex. The first part presented differences in growth and development in relation to prematurity. This part deals with risk factors for prematurity. The study revealed that low educational level of fathers and parental smoking were significant risk factors for prematurity. The mean age of both parents and mothers’ gravidity were significantly higher for prematures. Other risk factors were identified. Mothers with diabetes and chronic nephritis were more likely to have a premature child

Pattern of growth and development of premature children at the age of two and three years in Alexandria, Egypt [Part I

A case-control study was conducted in Alexandria on 68 premature children:32 of them at the age of 2 and 36 at the age of three years. The aim was to depict the pattern of growth and development among them. Controls were full-term children, who were double the number of prematures and matched by age and sex. It was found that the growth pattern of full-term children aged two and three years was better than that of prematures. Moreover, prematures were significantly delayed in some developmental areas as language, fine motor-adaptive sectors and personal-social domains than their corresponding controls. The study suggests that the provision of quality medical care could eliminate the growth and developmental lag of premature children

Sociodemographic impact of variables on cognitive, language and motor development in very preterm infants

BackgroundIn the last decades, the birth of premature babies has increased, it is important to know the impact of certain variables, especially in the most vulnerable groups. PurposeTo analyse the relationship of gestational age (GA), weight and sex of the children, as well as the educational level and age of the parents with the cognitive, motor and language development of a group of very preterm births, assessed at 36 months. Design and methodsThe research followed a descriptive, observational and cross-sectional design. Children's development was measured using the Bayley-III Scale. Descriptive analysis, bivariate and linear regression models were carried out. ResultsAlthough the cognitive, motor and language development is within average levels, worse results are evidenced in the group of extreme premature, as opposed to the very premature. Boys score lower than girls, with these differences being more pronounced in the motor area. It also shows how the education level of both parents is related to the levels of development at 3 years of age of children born very prematurely, especially in language. ConclusionsLower GA, male sex and lower parental educational level are associated with higher risk of developmental difficulties. Practice implicationsThe findings of this study are relevant to clinical practice because they suggest to develop protocols of evaluation and the follow up of all premature children beyond 36 months, as well as developing specific intervention programmes for the most vulnerable of the premature groups.

Effect of physical rehabilitation programs on the recovery sensorimotor functions in premature infants during the postnatal ontogenes’s period

Introduction.Improving the treatment of premature infants is one of the priorities in the development of perinatal care for children in Russia. The widespread introduction of modern high-tech methods of resuscitation of premature children has shown its effectiveness in improving their survival. However this has led to an increase in various health disorders. Therefore, it is extremely important to determine and practically use effective technologies of medical care that will not only save the lives of children born prematurely, but also significantly affect their health indicators in subsequent age periods.Purpose of the study. To study the influence of various physical rehabilitation programs on the development of adaptive reactions and correction of impaired sensorimotor functions in early postnatal ontogenesis in premature infants.Materials and methods.A comprehensive study of 120 infants in the first year of life was carried out, including functional testing, anthropometric, general clinical and physiological methods for the development and assessment of the impact of physical rehabilitation programs of different volume and content on sensorimotor development and the state of adaptive capabilities of the body of premature infants in the first year of life.Results.The maximum effectiveness of rehabilitation measures for premature infants of the first year of life was noted only with a combination of sympathetic type of autonomic regulation of the heart rate and a program that included therapeutic exercises, massage, dry immersion and hydrokinesitherapy. In premature babies with a pronounced predominance of sympathetic regulation of the heart rhythm, the smallest rehabilitation programs are most appropriate.Conclusions. When developing a physical rehabilitation program, it is necessary to take into account the state of the adaptive capabilities of the body of premature infants in the first year of life, which can be determined by the type of autonomic regulation of the heart rate.

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.

A molecular explanation of cardiovascular protection through abnormal cannabidiol: Involving the dysfunctional β-adrenergic and ATP-sensitive K+ channel activity in cardiovascular compromised preterm infants.

Growing cannabis efficacy, usage frequency, legal supply, and declining awareness of danger recently led to expanded United States cannabis exposure. In turn, cannabis use among elderly people over 50 has more than tripled in a decade and has contributed toward a positive association of cannabis use with pathological conditions, which include type II diabetes, metabolic syndrome, neurovascular and cardiovascular disease. Remarkably, all these outcome results are mediated by the involvement of the ATP-sensitive K+ channel. Cardiovascular compromise is a common syndrome in preterm infants that leads to incidence and death and has been distinguished by poor systemic flow or hypotension. Conditions of cardiovascular compromise include vasodysregulation and myocardial malfunction through dysfunctional β-adrenergic activity. To avoid organ hypoperfusion progressing to tissue hypoxia-ischemia, inotropic drugs are used. Many premature children, however, respond insufficiently to inotropic activity with adrenergic agonists. The clinical disturbance including myocardial dysfunction through the activation of the ATP-sensitive K+ channel is often involved and the comparative efficacy of the nonpsychotropic cannabinoid, abnormal cannabidiol(Abn-CBD) is not yet known. Therefore, our primary aim was to investigate the molecular exploration of the cannabinoid system specifically Abn-CBD in cardiovascular protection involving dysregulated KATP.

A comparison of posterior segment optical coherence tomography findings in full-term and preterm children without retinopathy of prematurity

Purpose:Structural differences have been described in the retina of prematurely born children, including increased macular thickness caused by failed migration of the inner retina during development and retinal nerve fiber layer (RNFL) thinning related to low birth weight. The present study aimed to evaluate the differences in macular and RNFL optical coherence tomography (OCT) findings between full-term and preterm children without retinopathy of prematurity (ROP).Methods:Thirty-four premature (study group) and 43 full-term patients (control group)—aged 3 to 8 years—were studied. All children underwent a complete ophthalmological exam and OCT of the macula and optic nerve in both eyes to determine macular and RNFL thickness and morphology. Correlation analysis between central macular thickness, age, and visual acuity was also performed.Results:Central macular thickness was greater in the study group than in the control group; a difference of 14.2 μm was observed for the right eye (P = 0.002) and 12.16 μm for the left eye (P = 0.019). The thickness of the parafoveal and the perifoveal zones was consistently greater in the study group. 44.3% of eyes in the study group had mild forms of foveal hypoplasia (grades 1a and 1b) in qualitative description. No correlation between central macular thickness and visual acuity was found. There was no difference in RNFL thickness between both groups.Conclusion:Statistically significant structural differences were found in the macula of premature children, with a greater foveal thickness possibly reflecting retention of the inner retina during development, with no repercussion over visual acuity. RNFL thickness was similar in both groups.

Cognitive Outcomes Following Intravitreal Bevacizumab for Retinopathy of Prematurity: 4- to 6-Year Outcomes in a Prospective Cohort

To determine the long-term cognitive outcomes in children who underwent intravitreal bevacizumab (IVB) for retinopathy of prematurity (ROP). Prospective cohort study. This single-center study enrolled 186 children between 3 and 6 years of age and included 101 children in the final analysis: premature without ROP (group 1), ROP not needing treatment (group 2), IVB monotherapy (group 3), IVB plus laser therapy (group 4), and laser monotherapy (group 5). The Full-Scale Intelligence Quotient (FSIQ) was evaluated by the Wechsler Preschool and Primary Scale of Intelligence Test at baseline and then annually for 1-2 years and compared among groups. The age at cognitive evaluation was 4.5-4.9 years at baseline and 6.1-7.0 years at the last follow-up. The FSIQ was comparable among the groups at both time points (P=.08 and .50, respectively). Severe cognitive impairment (FSIQ < 70) was more common in group 4 at baseline (4%, 22%, 13%, 33%, and 0% in groups 1-5, respectively; P=.03) but did not differ among the groups at the last follow-up (6%, 0%, 4%, 22%, and 0%; P=.22). After adjusting for sex, Apgar score, neonatal adverse events, and days on mechanical ventilation, IVB was not associated with FSIQ either at baseline or at the last follow-up. At 4.5 to beyond 6 years of age, children who underwent IVB monotherapy had comparable cognitive outcomes compared to the other premature children without prior IVB. Children who underwent IVB plus laser showed higher severe cognitive impairment at 4.5 years of age.

Nursing of prematurely born children: indicators of the effectiveness

The study and monitoring of international indicators of the health status of premature infants is the current vector of scientific research in neonatology.Objective. To assess the effectiveness of the nursing technologies of premature babies in the Republic of Belarus based on the analysis of long-term indicators of morbidity, mortality and survival of the infants with extremely low body weight.Material and methods. Statistical reports data were used for a retrospective analysis of epidemiological indicators for the period of 2002–2018.Results. The proportion of premature infants in the Republic of Belarus was stabilized at 4,2–4,5% increase in the absolute numbers, including those born weighing less than 1500 g. The ratio of the absolute number of alive and stillborn infants with extremely low body weight is many times higher than the initial values (p&lt;0,05). The survival rate of infants with a body weight of 500–999g up to 1 year increased 2 times to the maximum level in 2018 (81,5%). There was an increase in the overall incidence of premature children in 2002–2010 (p&lt;0,05) and a decrease by 2016 (p=0,001), including those born with a body weight of 500–999 g. Respiratory distress syndrome, intrauterine hypoxia and asphyxia during childbirth, an increase in the frequency of infections specific to the perinatal period (p &lt;0,05) were registered more often. Among the children born with a body weight of 500–999 g, the incidence of congenital pneumonia for the period 2002–2009 increased to a maximum level of 263,4 ‰ (p &lt;0,05) with a twofold decrease by 2018. The republican mortality rate of premature babies was stabilized at the level of 0,95 ‰ in the last 9 years, while the indicator was decreased 5 times among children weighing 500–999 g.Conclusion. The assessment of the long-term dynamics of the main indicators of the health status of premature infants in the Republic of Belarus testified to the effectiveness of a complex of organizational and medical measures for their nursing.

The Role of Iron Adequacy for Maternal and Fetal Health

Nearly half of pregnant women in the world are reported to suffer anemia. And most of them are caused by iron deficiency, while the others by folate, vitamin B12 or vitamin A deficiency, chronic inflammation, parasite infections and hereditary disorders. Anemia in pregnant women is characterized when &lt; 11 g / dL or any time during pregnancy. And when followed by low iron, it's called iron deficiency anemia.&#x0D; Iron plays an important role in many metabolic processes by transporting oxygen and allowing cells to generate energy. Low iron levels during pregnancy leading to anemia, related to an heightened risk of mother and fetus disease. Iron deficiency anemia can affect fetal development and persist long-term, while mild and serious pregnancy anemia can lead to premature birth, maternal and child mortality, bleeding, and infectious disease. The iron requirement during pregnancy exceeds 1000 mg for red cell expansion, 300 mg – 350 mg for developing fetus and placenta, and 250 mg for variable blood loss at delivery. Iron adequacy during pregnancy can be assured by proper nutrition, iron supplementation and fortification, and intravenous iron or blood transfusion. Iron supplementation is only enough to cover the prenatal iron requirements.&#x0D; Summary: Iron deficiency leading to anemia, rising risk of negative pregnancy outcomes. To meet increasing iron requirements during pregnancy including iron supplementation, fortification of staple iron foods, and intravenous iron or blood transfusion if required.

The meaning of NICU-Diaries to parents of premature children in the neonatal intensive care unit: Trust that everything will be fine

PurposeThe aim of the qualitative study was to explore the meaning of diaries for parents at the Neonatal Intensive Care Unit (NICU). FindingsBased on Reflexive Grounded Theory, eight parents could be interviewed. By using a NICU diary, parents develop trust that everything will be fine in the end. It appears to be relevant by providing a kind of communication with the child beyond the physical level, reducing hospital atmosphere, strengthening the relationship between parents and nurses, and filling gaps when parents cannot be at the unit. In dealing with the NICU diary, parents are able to adopt strategies for action which result in writing and reading of the diary. Gender-specific differences between mothers and fathers could be outlined. ConclusionThe NICU diary is a tool to support parents dealing with the situation at the NICU, establishing communication and humanizing critical care.

Анализ частоты встречаемости ретинопатии недоношенных по данным Республиканской детской клинической больницы за 2018-2020 гг.

Purpose. To analyze stages of retinopathy of prematurity (ROP) and it’s unfavorable active forms, and the correlation between severity of ROP and gestanational age and birth weight of children in Republican Children's Clinical hospital (RCCH). Material and methods. We have examined 4036 children including 759 children with ROP, 596 children had I and II stages, 105 children with III stage, 58 children with Aggressive Posterior ROP (APROP) and 42 children with Plus disease. Results. The structure of ROP for 3 years is: I and II stages – 78,5%, III stage – 13,83%, APROP – 7,64%. There is direct relation between retinal lasercoagulation (RLC) and gestanational age and birth weight: the less are the indexes, the more is probability of unfavorable prognosis and operation necessity. Conclusions. Screening of premature children in catamnesis cabinet in RCCH, regular ophthalmic monitoring with up-to-date diagnostic methods and opportune prophylactic RLC in active phase of ROP allow to decrease disability of ROP. Key words: retinopathy of prematurity, premature children, lasercoagulation of retina.

Clinical characteristics and features of the monocytic link of innate immunity in children with extremely low body weight and severe bronchopulmonary dysplasia

In order to assess the immunity indicators of early premature children born in the period from 22 to 27 weeks the researchers conducted a dynamic examination of 24 newborns: 11 children with severe bronchopulmonary dysplasia (Group 1) and 13 children without bronchopulmonary dysplasia (Group 2). They used flow cytometry to determine monocyte counts (CD14+CD64+, CD14+HLA-DR+, CD11b+CD14+). The authors determined the peculiarities of the immune status of children with severe bronchopulmonary dysplasia. They found that the spectrum of monocyte-macrophage protection factors of the children with extremely low body weight was significantly reduced due to a decrease in cell adhesion and migration of the (CD14+CD64+) cells to the inflammation site, as well as the presentation of infectious pathogens – viruses or bacteria (CD14+HLA-DR+), which may be the reason for the development of bacterial complications and prolonged course of the inflammatory process, one of the main factors in the development of severe bronchopulmonary dysplasia. The revealed features of the immune status in infants with bronchopulmonary dysplasia can be used to evaluate the effectiveness of the therapy, which dictates the need for further studies.

Paying attention to cerebral/central visual impairment

Cerebral/central visual impairment (CVI) has a wide range of features owing to central visual pathway disorders. It is currently the most common type of visual impairment in children in developed countries and is increasing in the developing world. The major cause of CVI is hypoxic-ischemic encephalopathy in premature children. CVI occurs from the postgeniculate visual pathway to the occipital lobe and results in severe visual impairment and even blindness. CVI may also lead to visual cognitive disability, walk difficulty, delayed social interaction and autism spectrum. These children are less likely to live independently, and this will impose huge costs on families and society. Therefore, much more care and attention should be paid to CVI. (Chin J Ophthalmol, 2021, 57: 321-325).

Evaluación de la función tiroidea en el recién nacido pretérmino o de muy bajo peso

The screening program or early detection of congenital hypothyroidism is one of the greatest advances achieved in Pediatrics. Thyroid hormones are essential for brain development and maturation, which continue into the neonatal stage. Alterations in thyroid function in premature and underweight children in the first months of life causes irreversible damage to the central nervous system and is one of the most frequent and avoidable causes of mental retardation. Diagnosis in the neonatal period is difficult, so it requires an analytical study to be able to carry out the appropriate treatment.The relevance of this problem justifies its communication to all areas of pediatrics. The main objective is to avoid brain damage in these patients. Other aspects to optimize the adequate development of these children with all the necessary periodic controls and to achieve the inclusion of the diagnosis of thyroid alterations during the stay in neonatal units and in the first months of life, need to implement the resources of the health centers and continue advancing according to current knowledge.In this document, we will focus on the screening of preterm newborns VLBW (<32 weeks of gestation) and/or very low weight for gestational age (1500-1000g VLBW or <1000g) and the function evaluation protocol thyroid in premature babies.We update the diagnostic procedures, the essential and complementary tests required, the etiology and the differential diagnoses in this pathology.

Early childhood caries among premature children enrolled in WIC: A retrospective case - Controlled study

Purpose: To investigate the association between premature birth and Early Childhood Caries (ECC) experience, while secondarily evaluating factors that may influence development of caries. Methods: Data collected from patients enrolled at the University of Iowa’s Infant Oral Health Program consisted of prenatal history, child’s demographics, neonatal history, oral hygiene, dietary habits, and clinical findings (visible plaque, enamel defects, and caries). Bivariate and logistic regression analyses were utilized (alpha=0.05). Results: Four hundred and ninety eight randomly matched premature and full-term subjects were included (mean age=21 months [range: 6-71 months]; 51.4% males and 38.9% African Americans). Bivariate analysis revealed no significant differences existed regarding cavitated and non-cavitated caries experience between full-term and premature subjects. Additionally, compared to their counterparts, premature subjects were more likely to eat cariogenic snacks between meals (P=0.028), drink cariogenic beverages &gt;2 times per day (P=0.027), not have their teeth brushed daily (P&lt;0.001), and less likely to have seen a dentist (P=0.04). Logistic regression analysis showed that showed number of teeth present (OR=1.24, 95% CI: 1.10-1.39 ; P&lt;0.001) and visible plaque on maxillary incisors (OR=5.69, 95% CI: 2.22-14.55; p&lt;0.001) to be significantly associated with ECC in premature subjects. Conclusions: While there was no evidence that prematurity was associated with ECC, premature subjects had cariogenic dietary behaviors and high-risk oral hygiene behaviors.

Childhood Asthma and Smoking: Moderating Effect of Preterm Status and Birth Weight.

IntroductionAlthough studies have examined the association between childhood asthma and parental smoking and secondhand smoke, little research has explored the moderating role of birth weight and prematurity (BWP) status on this association. We examined the association between secondhand smoke exposure, asthma, and asthma severity in children aged six to 17 as well as the modifying effect of BWP on parental smoking and asthma.MethodsWe used data from 36,954 children from the National Survey of Children’s Health 2017-2018. In addition to univariate analysis, adjusted and unadjusted logistic regression models were used to estimate the effect of secondhand smoke on asthma. The interaction term between parental smoking and BWP was tested. Multinomial regression was used to evaluate the association between secondhand smoke on asthma severity.ResultsAbout 15.1 % of children had asthma and 15.4% of parents reported smoking. Odds of asthma were higher in children living with an outdoor (AOR, 1.27; 95% CI, 1.06-1.52) and indoor (AOR, 1.46; 95% CI, 1.01-2.11) smoker in the adjusted model. The association of parental smoking with asthma differed by birth weight and premature status. Normal weight children who are premature had the highest odds ratio (AOR, 2.15; 95% CI, 1.2-3.86). In the multinomial model, low birth weight and premature children had higher odds of mild (AOR, 1.90; 95% CI, 1.40-2.56) and moderate/severe (AOR, 1.81; 95% CI, 1.16-2.84) asthma compared to the no asthma group.ConclusionThe Association of parental smoking on asthma was modified by BWP. Focused asthma interventions in children should inquire about BWP status as well as parental smoking and household smoke exposure to reduce asthma morbidity and mortality.

Physical, Perceptual, Socio-Relational, and Affective Skills of Five-Year-Old Children Born Preterm and Full-Term According to Their Body Mass Index.

The main purpose of this study was to compare the psychomotor development of five-year-old children born preterm and full term. The comparison included physical-motor, perceptual-motor, and socio-relational and affective skills. As low weight is one of the variables that most influences the psychomotor development of premature infants, a secondary aim was to analyze these skills according to their current body mass index (BMI). A prospective simple ex-post facto study was conducted. The sample consisted of 672 five-year-old children enrolled in the third year of early childhood education in the province of Albacete, Spain; 35 of them was born prematurely. Children were evaluated by their teachers using the Checklist of Psychomotor Activities (CPA). The results show that children born preterm had a lower development of their physical-motor skills. In the perceptual-motor field, premature children showed lower scores in the variables related to their body image and body schema, motor dissociation, and visual-motor coordination, as well as in socio-relational and affective aspects. However, the development in laterality, dynamic coordination, motor execution, tonic-postural control, and balance were not affected. These differences were not affected by the current weight, given that the analysis of the BMI indicated no differences in preterm children. This study demonstrated the need to establish protocols oriented to the prevention of the difficulties detected in children with psychomotor high-risk and the needs to reinforce the educational programs in this area to improve the integral development of children born preterm.