8 results on '"Tammela, O"'
Search Results
2. The effect of birth in secondary- or tertiary-level hospitals in Finland on mortality in very preterm infants: a birth-register study.
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Rautava L, Lehtonen L, Peltola M, Korvenranta E, Korvenranta H, Linna M, Hallman M, Andersson S, Gissler M, Leipälä J, Tammela O, Häkkinen U, and PERFECT Preterm Infant Study Group
- Published
- 2007
- Full Text
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3. Visual and Hearing Impairments After Preterm Birth.
- Author
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Hirvonen M, Ojala R, Korhonen P, Haataja P, Eriksson K, Gissler M, Luukkaala T, and Tammela O
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- Adult, Female, Finland epidemiology, Gestational Age, Humans, Infant, Newborn, Infant, Premature physiology, Male, Registries, Risk Factors, Hearing Disorders diagnosis, Hearing Disorders epidemiology, Premature Birth diagnosis, Premature Birth epidemiology, Vision Disorders diagnosis, Vision Disorders epidemiology
- Abstract
Objectives: Our aim was to determine and compare the incidences of sensory impairments among very preterm (VP) (<32 + 0/7 weeks), moderately preterm (MP) (32 + 0/7-33 + 6/7 weeks), late preterm (LP) (34 + 0/7-36 + 6/7 weeks), and term infants (≥37 weeks) and to establish risk factors of neurosensory disabilities., Methods: This national register study included all live-born infants in Finland between 1991 and 2008. Infants who died before the age of 1 year, who had any major congenital anomaly, or had missing data were excluded ( n = 21 007; 2.0%). A total of 1 018 256 infants were analyzed. Incidences of hearing loss, visual disturbances or blindness, other ophthalmologic disorders, and retinopathy of prematurity were determined for gestational age (GA) groups. Risk factors of hearing loss and visual disturbances or blindness were analyzed., Results: The incidences of sensory impairments decreased with advancing GA at birth ( P < .001). The most prominent factors associated with increased risks of hearing loss and visual impairment were intracranial hemorrhage and convulsions. VP (odds ratio [OR] 2.34; 95% confidence interval [CI] 1.75-3.14) and LP (OR 1.26; 95% CI 1.04-1.52) births were associated with an increased risk of hearing loss, and VP (OR 1.94; 95% CI 1.55-2.44), MP (OR 1.42; 95% CI 1.11-1.80), and LP (OR 1.31; 95% CI 1.16-1.49) births predicted an increased risk of visual impairment., Conclusions: Incidences of sensory impairment decreased with increasing GA at birth. The most prominent risk factors predictive of sensory disabilities were intracranial hemorrhage and convulsions. VP and LP births were associated with an increased risk of hearing loss, and VP, MP, and LP births were associated with an increased risk of visual impairment., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2018 by the American Academy of Pediatrics.)
- Published
- 2018
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4. Cerebral palsy among children born moderately and late preterm.
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Hirvonen M, Ojala R, Korhonen P, Haataja P, Eriksson K, Gissler M, Luukkaala T, and Tammela O
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- Anti-Bacterial Agents adverse effects, Anti-Bacterial Agents therapeutic use, Apgar Score, Child, Child, Preschool, Female, Finland, Humans, Incidence, Infant, Intracranial Hemorrhages diagnosis, Intracranial Hemorrhages epidemiology, Longitudinal Studies, Male, Nonlinear Dynamics, Registries, Resuscitation, Risk Factors, Cerebral Palsy diagnosis, Cerebral Palsy epidemiology, Gestational Age, Infant, Premature, Diseases diagnosis, Infant, Premature, Diseases epidemiology
- Abstract
Objective: To compare the incidence of and risk factors for cerebral palsy (CP) in moderately preterm (MP) (32(+0)-33(+6) weeks) and late preterm (LP) (34(+0)-36(+6) weeks) infants with those in very preterm (VP) (<32(+0) weeks) and term infants (≥37 weeks)., Methods: The national register study included all live-born infants in Finland from 1991 to 2008. Infants who died before the age of 1 year, had any major congenital anomaly, or had missing data were excluded. A total of 1 018 302 infants were included in the analysis and they were analyzed in 4 subgroups (VP, MP, LP, and term) and 3 time periods (1991-1995, 1996-2001, and 2002-2008)., Results: By the age of 7 years, 2242 children with CP were diagnosed (0.2%). CP incidence was 8.7% in the VP, 2.4% in the MP, 0.6% in the LP, and 0.1% in the term group. The risk of CP was highest in the study period 1991-1995 in all groups. Factors predictive of an increased CP risk in the MP and LP groups included resuscitation at birth (odds ratio 1.60; 95% CI 1.01-2.53 and 1.78; 1.09-2.90), antibiotic treatment during the first hospitalization (1.63; 1.08-2.45 and 1.67; 1.13-2.44), 1-minute Apgar score <7 (1.70; 1.15-2.52 and 1.80; 1.21-2.67) and intracranial hemorrhage (7.18; 3.60-14.3 and 12.8; 5.58-29.2)., Conclusions: The incidence of CP is higher in LP and MP infants compared with term infants. There is a nonlinear decrease in incidence over time and with increasing gestational age., (Copyright © 2014 by the American Academy of Pediatrics.)
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- 2014
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5. Impact of very preterm birth on health care costs at five years of age.
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Korvenranta E, Lehtonen L, Rautava L, Häkkinen U, Andersson S, Gissler M, Hallman M, Leipälä J, Peltola M, Tammela O, and Linna M
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- Case-Control Studies, Child, Preschool, Female, Finland, Follow-Up Studies, Gestational Age, Hospitalization economics, Humans, Infant, Infant, Newborn, Male, Patient Care Team economics, Referral and Consultation economics, Social Welfare economics, Health Care Costs statistics & numerical data, Infant, Premature, Diseases economics, Infant, Very Low Birth Weight, National Health Programs economics
- Abstract
Objective: We assessed the effects of very preterm birth (gestational age <32 weeks or birth weight <1501 g) and prematurity-related morbidities on health care costs during the fifth year of life., Methods: The study population consisted of 588 very preterm children and 176 term control subjects born in 2001-2002. Costs of hospitalizations, visits to health care professionals and therapists, and the use of other social welfare services were assessed during the fifth year of life. Hospital visits were derived from register data and other health care contacts, and the use of social welfare services were derived from parental reports. The effects of 6 prematurity-related morbidities (cerebral palsy [CP], seizure disorder, obstructive airway disease, hearing loss, visual disturbances or blindness, and other ophthalmologic problems) on the costs of health care were studied., Results: The average health care costs during the fifth year of life were 749 euro in the term control subjects, 1023 euro in the very preterm children without morbidities, and 3265 euro in those with morbidities. The costs of social welfare services and therapies exceeded the hospitalization costs in all groups. Among children who were born preterm, CP was associated with 5125 euro higher costs, whereas later obstructive airway diseases increased the costs by 819 euro compared with individuals without these morbidities., Conclusions: The health care costs during the fifth year of life in very preterm children with morbidities were 4.4-fold and in those without morbidities 1.4-fold compared with those of term control subjects. This emphasizes the importance of prevention of morbidities, especially CP, to reduce the long-term costs of prematurity.
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- 2010
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6. Morbidities and hospital resource use during the first 3 years of life among very preterm infants.
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Korvenranta E, Lehtonen L, Peltola M, Häkkinen U, Andersson S, Gissler M, Hallman M, Leipälä J, Rautava L, Tammela O, and Linna M
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- Ambulatory Care statistics & numerical data, Cerebral Palsy therapy, Child Development, Chronic Disease economics, Finland epidemiology, Gestational Age, Humans, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases economics, Length of Stay economics, Outcome Assessment, Health Care, Patient Readmission economics, Patient Readmission statistics & numerical data, Registries, Retrospective Studies, Chronic Disease epidemiology, Infant, Premature, Diseases epidemiology, Length of Stay statistics & numerical data
- Abstract
Objective: The objective of this study was to determine how the use of hospital resources during the first 3 years of life was associated with prematurity-related morbidity in very preterm infants (gestational age of <32 weeks or birth weight of <1501 g)., Methods: The study was a retrospective, national register study including all very preterm infants born alive in Finland between 2000 and 2003 (N = 2148). Infants who died before the age of 3 years (n = 264) or who had missing register data (n = 88) were excluded from the study. The relationship between 6 morbidity groups and the need for hospital care during the first 3 years of life was studied by using a negative binomial model., Results: A total of 66.2% of the infants did not have any of the morbidities studied. Infants who were subsequently diagnosed as having cerebral palsy (6.1% of the study group), later obstructive airway disease (20.0%), hearing loss (2.5%), visual disturbances or blindness (3.8%), or other ophthalmologic problems (13.4%) had initial hospital stays that were a mean of 7, 8, 12, 17, and 3 days longer, respectively, than those for infants without these conditions. All morbidity groups were associated with increased numbers of hospital visits during either the second or third year of life, compared with infants without these morbidities. The need for hospitalizations and outpatient hospital care decreased with postnatal age for infants with later morbidities and for infants without later morbidities., Conclusions: Most very preterm infants born in Finland survived without severe morbidities and required relatively little hospital care after the initial discharge. However, those with later morbidities had a long initial length of stay and more readmissions and outpatient visits during the 3-year follow-up period.
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- 2009
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7. Randomized trial of a single repeat dose of prenatal betamethasone treatment in imminent preterm birth.
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Peltoniemi OM, Kari MA, Tammela O, Lehtonen L, Marttila R, Halmesmäki E, Jouppila P, and Hallman M
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- Female, Humans, Infant, Newborn, Male, Prenatal Care, Single-Blind Method, Betamethasone administration & dosage, Glucocorticoids administration & dosage, Intracranial Hemorrhages prevention & control, Premature Birth, Respiratory Distress Syndrome, Newborn prevention & control
- Abstract
Background: A single dose of prenatal betamethasone treatment decreases neonatal morbidity rates when administered within 7 days before preterm delivery. A single repeat dose or booster dose of betamethasone before delivery has been proposed to be effective, but its efficacy has not been subjected to a randomized, blinded trial., Methods: Women with imminent delivery before 34.0 gestational weeks were eligible if they remained without delivery for >7 days after a single course of betamethasone. After stratification, a single repeat dose of betamethasone (12 mg) or placebo was administered. The primary outcome was survival without respiratory distress syndrome or severe intraventricular hemorrhage (grade 3 or 4)., Results: A total of 249 mothers had been enrolled by the time the study was discontinued. All of the 159 infants in the betamethasone group and 167 in the placebo group were born before 36 weeks of gestation. The intact survival rate was unaffected and was lower than anticipated, because the gestational age-adjusted incidence of respiratory distress syndrome was higher than the population incidence. The requirement for surfactant therapy in respiratory distress syndrome was increased in the betamethasone group. According to posthoc analysis of the data for 206 infants who were delivered within 1 to 24 hours, the betamethasone booster tended to increase the risk of respiratory distress syndrome and to decrease intact survival rates., Conclusions: According to this study, a single booster dose of betamethasone just before preterm birth may perturb respiratory adaptation. These results caution against uncontrolled use of a repeat dose of glucocorticoid in high-risk pregnancies.
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- 2007
- Full Text
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8. Neurodevelopmental outcome at 5 years of age of a national cohort of extremely low birth weight infants who were born in 1996-1997.
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Mikkola K, Ritari N, Tommiska V, Salokorpi T, Lehtonen L, Tammela O, Pääkkönen L, Olsen P, Korkman M, and Fellman V
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- Child, Preschool, Cognition, Cohort Studies, Developmental Disabilities epidemiology, Finland, Humans, Infant Mortality, Infant, Newborn, Infant, Premature, Morbidity, Neuropsychological Tests, Risk Factors, Child Development, Developmental Disabilities etiology, Infant, Very Low Birth Weight growth & development
- Abstract
Objective: Increasing survival of extremely low birth weight (ELBW; birth weight < 1000 g) infants raises a concern regarding the risks of adverse long-term outcome such as cognitive dysfunction. Few studies have reported long-term follow-up of representative regional cohorts. The objective of this study was to assess the 5-year outcome of a prospectively followed national ELBW infant cohort., Methods: Of all live-born ELBW infants (n = 351) who were delivered in the 2-year period 1996-1997 in Finland, 206 (59%) survived until the age of 5 years. Of these, 103 were born at < 27 gestational weeks (GW). A total of 172 children were assessed with neurocognitive tests (Wechsler Preschool and Primary Scale of Intelligence-Revised and a Developmental Neuropsychological Assessment [NEPSY]). Nine children with cognitive impairment and inability to cooperate in testing were not assessed. Motor development was assessed with a modified Touwen test., Results: The rate of cognitive impairment in the ELBW survivors was 9%. The rate of cerebral palsy was 14% (19% of ELBW infants who were born at < 27 GW). The mean full-scale IQ of the assessed children was 96 +/- 19 and in children of GW < 27 was 94 +/- 19. Attention, language, sensorimotor, visuospatial, and verbal memory values of NEPSY assessment were significantly poorer compared with normal population means. Four percent needed a hearing aid, and 30% had ophthalmic findings. Of 21 children who had been treated with laser/cryo for retinopathy of prematurity, 17 (81%) had abnormal ophthalmic findings. Of the whole cohort, 41 (20%) exhibited major disabilities, 38 (19%) exhibited minor disabilities, and 124 (61%) showed development with no functional abnormalities but subtle departures from the norm. Only 53 (26%) of the total ELBW infant cohort were classified to have normal outcome excluding any abnormal ophthalmic, auditory, neurologic, or developmental findings. Being small for gestational age at birth was associated with suboptimal growth at least until age 5., Conclusions: Only one fourth of the ELBW infants were classified as normally developed at age 5. The high rate of cognitive dysfunction suggests an increased risk for learning difficulties that needs to be evaluated at a later age. Extended follow-up should be the rule in outcome studies of ELBW infant cohorts to elucidate the impact of immaturity on school achievement and social behavior later in life.
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- 2005
- Full Text
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