Developmental Outcomes of Extremely Preterm Infants with a Need for Child Protective Services Supervision.
The Journal of pediatrics
Outcomes of Extremely Preterm Infants With Birth Weight Less Than 400 g
2019; 173 (5): 434–45
Discordance in Antenatal Corticosteroid Use and Resuscitation Following Extremely Preterm Birth
JOURNAL OF PEDIATRICS
2019; 208: 156-+
Neurodevelopmental outcomes among extremely premature infants with linear growth restriction
JOURNAL OF PERINATOLOGY
2019; 39 (2): 193–202
OBJECTIVE: To evaluate neurodevelopmental outcomes of preterm infants with need for Child Protective Services (CPS) supervision at hospital discharge compared with those discharged without CPS supervision.STUDY DESIGN: For infants born at <27weeks of gestation between 2006 and 2013, prospectively collected maternal and neonatal characteristics and 18- to 26-month corrected age follow-up data were analyzed. Bayley-III cognitive and language scores of infants with discharge CPS supervision were compared with infants without CPS supervision using regression analysis while adjusting for potentially confounding variables, including entering CPS after discharge from the hospital.RESULTS: Of the 4517 preterm infants discharged between 2006 and 2013, 255 (5.6%) were discharged with a need for CPS supervision. Mothers of infants with CPS supervision were significantly more likely to be younger, single, and gravida ≥3; to have less than a high school education; and to have a singleton pregnancy and less likely to have received prenatal care or antenatal steroids. Despite similar birth weight and medical morbidities, the CPS group had longer hospital stays compared with the non-CPS group. In adjusted analysis, cognitive scores were points lower (B = -1.94; 95% CI, -3.88 to -0.08; P = .04) in the CPS at discharge group compared with the non-CPS group. In children who entered CPS supervision after hospital discharge (an additional 106 infants), cognitive scores were 4 points lower (beta=-4.76; 95% CI, -7.47 to -2.05; P<.001) and language scores were 5 points lower (beta=-4.93; 95% CI, -8.00 to -1.86; P=.002).CONCLUSION: Extremely preterm infants discharged from the hospital with CPS supervision or entering CPS postdischarge are at increased risk for cognitive delay at 2years of age. Opportunities exist to intervene and potentially improve outcomes in this vulnerable group of children.
View details for DOI 10.1016/j.jpeds.2019.07.063
View details for PubMedID 31500860
Behavioral problems are associated with cognitive and language scores in toddlers born extremely preterm
EARLY HUMAN DEVELOPMENT
2019; 128: 48–54
Consensus Statement on Standard of Care for Congenital Myopathies
JOURNAL OF CHILD NEUROLOGY
2012; 27 (3): 363-382
To compare neurodevelopmental outcomes in linear growth-restricted (LGR) infants born <29 weeks with and without weight gain out of proportion to linear growth.We compared 2-year neurodevelopmental outcomes between infants with and without LGR and between LGR infants with and without weight gain out of proportion to linear growth. The outcomes were Bayley-III cognitive, motor, and language scores, cerebral palsy, Gross Motor Function Classification System (GMFCS) level ≥ 2, and neurodevelopmental impairment.In total, 1227 infants were analyzed. LGR infants were smaller and less mature at birth, had higher BMI, and had lower Bayley-III language scores (82.3 vs. 85.0, p < 0.05). Among infants with LGR, infants with high BMI had lower language scores compared with those with low-to-normal BMI (80.8 vs. 83.3, p < 0.05), and were more likely to have GMFCS level ≥2 and neurodevelopmental impairment.Among infants with LGR, weight gain out of proportion to linear growth was associated with poorer neurodevelopmental outcomes.
View details for PubMedID 30353080
Recent progress in scientific research has facilitated accurate genetic and neuropathological diagnosis of congenital myopathies. However, given their relatively low incidence, congenital myopathies remain unfamiliar to the majority of care providers, and the levels of patient care are extremely variable. This consensus statement aims to provide care guidelines for congenital myopathies. The International Standard of Care Committee for Congenital Myopathies worked through frequent e-mail correspondences, periodic conference calls, 2 rounds of online surveys, and a 3-day workshop to achieve a consensus for diagnostic and clinical care recommendations. The committee includes 59 members from 10 medical disciplines. They are organized into 5 working groups: genetics/diagnosis, neurology, pulmonology, gastroenterology/nutrition/speech/oral care, and orthopedics/rehabilitation. In each care area the authors summarize the committee's recommendations for symptom assessments and therapeutic interventions. It is the committee's goal that through these recommendations, patients with congenital myopathies will receive optimal care and improve their disease outcome.
View details for DOI 10.1177/0883073812436605
View details for Web of Science ID 000301794400011
View details for PubMedID 22431881