Showing posts with label birth weight. Show all posts
Showing posts with label birth weight. Show all posts

Friday, September 11, 2015

Very Low Birth Weight Infants As Adults: How Are Their Lungs Doing?

By: Lewis First, MD, MS; Editor-in-Chief   
David Quitoriano

     We, along with other journals, are finding ourselves publishing more and more studies on long-term outcomes of former preterm infants as they grow and develop.  Recently, thanks to the neonatal inroads made at the start of life, even the highest risk infants are not only surviving, but many are thriving into adulthood.  While we are certainly interested in developmental outcomes of these infants as seen in the myriad of articles published in this area, there is less available about the medical complications of prematurity that may still exist in terms of adult health and wellbeing. 
      Yet this week, Saarenpaa et al. (doi: 10.1542/peds.2014-2651) share with us the results of a longitudinal population of 160 very low birth weight (VLBW) infants and a matched control group in Norway in terms of their pulmonary function when restudied at 18 to 27 years of age.  Infants with and without bronchopulmonary dysplasia (BPD) were separated into their own groups, and yet even without BPD, former VLBW infants who are now adults are showing reduced airflow, increasing their risk for obstructive airway disease as they age.   
      If you have former VLBW infants now growing up in your practice, this is a study to know about and share with the families of those patients, so appropriate attention can be paid for monitoring respiratory status in these patients as they get older and leave your practice.   You and your VLBW patients may breathe more easily learning what this study has to say about the respiratory status of this special population of patients.

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Monday, May 11, 2015

Why Would an Article on Alzheimer Disease Appear in Pediatrics?

By: Lewis First, MD, MS; Editor-in-Chief   

          Hopefully the headline for today’s blog caught your attention.  What’s our interest in Alzheimer Disease in a pediatric journal? Believe it or not, two markers of insulin resistance have been associated in adults with an increased risk of developing Alzheimer Disease and dementia, and Luciano et al. (doi:10.1542/peds.2014-2391) opted to look for these markers early by measuring them in normal, overweight, and obese preschoolers and adolescents.  
      Correlations of the Alzheimer biomarkers were significantly associated with elevated body mass index (BMI) in conjunction with insulin resistance suggesting that perhaps seeing these markers early on may signal a later risk of developing the cognitive abnormalities associated with Alzheimer Disease and dementia.  How these markers in childhood might result in the brain changes that cause this disease of adults and what we might do about this while our patients are still young raises perhaps more questions than answers—but that’s what reading our journal is all about.  
     Hopefully an article like this will raise awareness enough to trigger other studies to confirm these findings, follow the cohort of overweight and obese children with insulin resistance and see if reducing the level of resistance also improves mentation as these children age.  Read this study and you’ll see yet another example of how the prevention work we strive to do as pediatricians pays off not just in childhood but throughout our patients’ lives.

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Tuesday, February 10, 2015

Extremely Low Birth Weight Infants Now in Their 30s: How’s Their Mental Health?

By: Lewis First, MD, MS; Editor-in-Chief

@singingbeagle Flickr

          It is amazing how much we learn from longitudinal follow-ups of our patients. What was once only a follow-up of a few years tracking a cohort (if we were lucky to keep collecting data on them) has evolved into decades of tracking patients since infancy—and preterm infants are a great example. 
This week Van Lishout et al. (doi: 10.1542/peds.2014-3143) report on a prospective longitudinal population-based cohort of extremely low birth weight (ELBW) infants followed for over three decades in Ontario Canada. This cohort was mixed with an equal number of non-ELBW infants in their 30s and were interviewed in regard to their mental health as adults with interviewers unaware of early birth history. 
The results are interesting and reflect that ELBW adults are less likely to have alcohol or substance abuse problems but a greater risk of non-substance related mental health issue including generalized anxiety, and attention-deficit/hyperactivity disorder. Risks increased for both substance and non-substance related psychiatric disorders if antenatal corticosteroids had been administered. 
          While we realize we don’t usually follow our patients into their 30s, the information in this study is useful for educating both parents and adolescent patients to perhaps be better aware of problems that might occur more frequently as they move into adulthood, and at the same time take preventive steps to reduce the occurrence of such problems knowing what this study tells us.  Kudos to the investigators for being able to follow this ELBW cohort for so long and in turn for sharing with us information that can influence how we counsel these patients while they are still in our practice.

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