Showing posts with label late preterm infants. Show all posts
Showing posts with label late preterm infants. Show all posts

Friday, October 16, 2015

Familiar with Early-Onset Neutropenia in a Small for Gestational Age Infant? After Reading a New Study You Will Be!

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


        Small for gestational age (SGA) infants are known to have early neutropenia when compared to normal size infants at a gestational age—but just what do we know about this neutropenia?  How common is it? How long does it last?  What might be causing it and what makes it better?  
       These questions and more are answered in an informative study by Christensen et al. (doi: 10.1542/peds.2015-1638) being released this month in our journal who looked at ten years of neutropenia in the first week of life in more than 200 SGA infants out of 3600 studied compared to less than 50 out of 3650 non-SGA infants.  The authors looked at a variety of factors associated or not-associated with this neutropenia ranging from necrotizing enterocolitis to thrombocytopenia and give us a much clearer picture of what the “neutropenia of SGA” is all about.  
        If you want to know more about a common finding in your SGA newborns and what to follow and worry about (or not) in this neutropenic population, then reading this study should be an easy “cell.”

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Wednesday, August 12, 2015

Are There Differences in School Readiness for Late Preterm Infants Compared to Term? New Study Says Yes!


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

          How often do parents ask us if their child is ready to start kindergarten despite their meeting the age requirement?  This is especially common for parents of children born been born preterm—but what about late preterm infants 34 to 36 weeks gestation?
Woythaler et al. (doi: 10.1542/peds.2014-4043) opted to look at neurodevelopmental outcomes using a longitudinal cohort population of 950 late preterm babies, comparing them to more than 4900 term infants to see if their 24-month developmental assessment correlated with their “school readiness score” using a valid assessment tool once the subjects were age-appropriate for kindergarten.     
 The good news is that just because a late preterm infant has delayed neurodevelopment at 24 months does not mean he or she won’t be improved neurodevelopmentally by the time they are ready to enter kindergarten.  If a late preterm is developmentally on target at 20 months, the prognosis is good for moving into kindergarten when age-appropriate.  
 Have you noticed the same findings in your own patients? Do you note any developmental differences in your late preterm patients as they get older?  Share your thoughts and experience with us by responding to this blog, sending an e-letter or posting on our Facebook or Twitter sites.

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Monday, March 30, 2015

Follow-up Studies of Preterm and Late Preterm Infant Neurocognitive Performance Continue To Develop


By: Lewis First, MD, MS; Editor-in-Chief  
  
     Our readers tell us they learn a lot reading the studies we publish on long-term follow-up of infants born early particularly in terms of their neurodevelopment. Well this week we don’t want to disappoint our readers and therefore bring you three studies of interest in the area of cognitive development of preterm, and late preterm infants. 
      The first study by Burnett et al. (doi: 10.1542/peds.2014-3188) focuses on extremely preterm (less than 28 weeks) and extremely low birth weight (less than1000 g) infants in terms of their executive function, not just in infancy and toddlerhood but into adolescence. 
     Sadly, poor performance in executive function tasks seen early in life carries on into the teen years, and while some aspects of executive function improve over time, a number of aspects do not, suggesting the need to intervene sooner than later to try to further develop executive function skills over time.
      A second study by Heinonen et al. (doi: 10.1542/peds.2014-3556) looks at late preterm infants and follows their neurocognitive performance not just into adolescence, but into late adulthood. The authors traced a cohort of more than 900 men and women born in Finland in 1934-44 who were assessed  as adults with a battery of tests to identify signs of Alzheimer disease and believe it or not, those who were identified as late-preterm had a higher risk of showing neurocognitive impairment.  Interestingly enough however, those who were able to pursue higher education did not show such findings. 
     Finally there is a third study by Schonhaut et al. (doi:10.1542/peds.2014-1957)  that looks at developmental impairment relative to gestational age in moderate, late preterm and early term infants and once again, there is an inverse association between gestational age and developmental delay.
     There are a lot of interesting comments one can make about the findings in all three studies, and at the same time, one has to be amazed that cohorts of infants are now being followed not just into early childhood but through adolescence and into adulthood without major losses to follow-up.  As a result, we are learning more and more about the developmental outcomes associated with being born early.   
     To help make even more sense of these types of studies and what we can do to perhaps improve developmental outcomes in these patients, Dr. Betty Vohr (doi: 10.1542/peds.2015-0227) offers her perspective in a very interesting commentary.  Read all three studies and the commentary and then see what develops in regard to interventional strategies to improve developmental outcomes in these infants born preterm.

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Friday, March 6, 2015

Preterm and Late Preterm Infant Neurocognitive Performance Follow-up Studies Continue To Develop

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

         Our readers tell us they learn a lot reading the studies we publish on long-term follow-up of infants born early particularly in terms of their neurodevelopment. Well this week we don’t want to disappoint, and therefore bring you three studies of interest in the area of cognitive development of preterm, and late preterm infants. The first study by Burnett et al.  (doi:10.1542/peds.2014-3556) focuses on extremely preterm (less than 28 weeks) and extremely low birth weight (less than 1000 g) infants in terms of their executive function, not just in infancy and toddlerhood but into adolescence. 
         Sadly, poor performance in executive function tasks seen early in life carries on into the teen years, and while some aspects of executive function improve over time, a number of aspects do not, suggesting the need to intervene sooner than later to try to further develop executive function skills over time.
         A second study by Heinonen et al. (doi:10.1542/peds.2014-3556) looks at late preterm infants and follows their neurocognitive performance not just into adolescence, but into late adulthood. The authors traced a cohort of more than 900 men and women born in Finland in 1934-44 who were assessed  as adults with a battery of tests to identify signs of Alzheimer disease and believe it or not, those who were identified as late-preterm had a higher risk of showing neurocognitive impairment.  Interestingly enough however, those who were able to pursue higher education did not show such findings. 
          Finally there is a third study by Schonhaut et al. (doi:10.1542/peds.2014-1957)  that looks at developmental impairment relative to gestational age in moderate, late preterm and early term infants and once again, there is an inverse association between gestational age and developmental delay.
          There are a lot of interesting comments one can make about the findings in all three studies, and at the same time, one has to be amazed that cohorts of infants are now being followed not just into early childhood but through adolescence and into adulthood without major losses to follow-up.  As a result, we are learning more and more about the developmental outcomes associated with being born early.  To help make even more sense of these types of studies and what we can do to perhaps improve developmental outcomes in these patients, Dr. Betty Vohr (doi:10.1542/peds.2015-0227) offers her perspective in a very interesting commentary.  Read all three studies and the commentary and then see what develops in regard to interventional strategies to improve developmental outcomes in these infants born preterm.

Related Links: