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Difficulties in mathematics have been described in very preterm children, but their origins are not well understood and may differ from other populations with specific learning disability. Very preterm children, children with learning disability, and typically developing children were compared in mathematics skills, using standardized tools, experimental tasks, and eye-tracker measures. We assessed symbolic and nonsymbolic magnitude comparisons, number knowledge, calculation, as well as cognitive skills of 103 Italian-speaking fourth and fifth graders. Compared to typically developing peers, very preterm children showed delays in number knowledge, slower reaction times in nonsymbolic magnitude comparisons, and an atypical gaze exploration characterized by more and shorter fixations that lacked a target preference. The profile of mathematics skills of very preterm children appeared different from that of children with learning disability. Although both populations showed mainly preserved cognitive skills and slower reaction times in nonsymbolic magnitude comparisons, children with specific learning disability showed more severe impairments in calculation and were slower in symbolic magnitude comparisons, compared to very preterm children. Including eye-tracking measures in preterm follow-up programs and planning tailored interventions are recommended.

The present study examined maternal responses to infants' spontaneous communicative behaviors in a sample of 20 extremely-low-gestational-age (ELGA) infants and 20 full-term (FT) infants during 30 minutes of play interaction when infants were 12 months of age. Relations between maternal responses and infants' communication skills at 12 and 24 months were investigated. Maternal responses were coded according to their contingency and degree of relevance to the infant's communicative signal. Despite the less advanced gestural abilities of ELGA infants, their mothers produced high percentages of contingent and relevant responses, as did mothers of their FT peers. Maternal contingent and highly relevant responses (i.e., those with a repeated label) were associated with ELGA infants' receptive and expressive communication skills at 12 months and predicted expressive communication skills at 24 months. Results suggest that contingent maternal responses with a repeated label following infants' spontaneous communicative behaviors support communicative development, particularly among ELGA infants.

This cross-linguistic study investigated whether the native language has any influence on lexical composition among Italian (N = 125) and Finnish (N = 116) very preterm (born at <32 gestational weeks) children at 24 months (controls: 125 Italian and 146 Finnish full-term children). The investigation also covered the effect of maternal education (ME) on lexical composition. The Italian/Finnish MacArthur Communicative Development Inventory was used for gathering the data. Although the lexicons of the preterm children were smaller than those of the controls, the native language had no major effect on their lexical composition. The ME had a significant effect on preterm children's lexical composition, especially in the Finnish children. The findings indicate that lexical composition is not strongly affected by preterm birth. They also imply that lexical composition is a robust phenomenon that is connected to lexicon size and is not language-specific when analysed in broad terms, although some language-specific features were also detected.

The present study involved a systematic longitudinal analysis, with three points of assessment in the second year of life, of gestures/actions, word comprehension, and word production in a sample of very preterm infants compared to a sample of full-term infants. The relationships among these competencies as well as their predictive value on language development at 24 months and the contribution of biological, medical and social risk factors on language delay at 24 months were also analysed. One hundred and four monolingual Italian very preterms (mean gestational age 29.5 weeks) without major cerebral damages, and a comparison group of 20 monolingual healthy Italian full-terms were followed at 12, 18 and 24 months by administering to their parents the Italian short forms of the MacArthur-Bates CDI. Preterms showed a slower acquisition in gesture/action production, word comprehension, and word production with an increasing divergence with respect to full-terms from 12 to 24 months, when 20% of preterms were delayed in word production (less than 10th percentile) and 14% did not combine words yet. Lexical competencies at 12 months and together with gestures/actions at 18 months were predictive of word production at 24 months, with a stronger contribution of word comprehension at 12 months and of word production at 18 months. Male gender, bronchopulmonary dysplasia, and low maternal educational level increased the risk of language delay at 24 months. Our findings suggest there to be a slower rate of communicative-linguistic development in very preterms with an increasing difference in their gestural and lexical competencies in the second year of life with respect to full-terms. The interplay of the above competencies and biological, medical and social risk factors increase the risk of language delay at 24 months in very preterm infants. (Contains 6 tables and 3 figures.)

The aims of this study were to investigate whether specific linguistic difficulties in preterm children persist at eight years and to examine the interrelationships between language and literacy in this population, compared with a control group of full-term children. Sixty-eight monolingual Italian preterms and 26 chronologically matched controls were recruited. Language (grammar comprehension, lexical production and phonological awareness), literacy (reading comprehension, reading and writing) and general cognitive development were investigated. Results showed no general delay in preterms, but slight difficulties in specific linguistic abilities (grammar, lexicon, phoneme synthesis and deletion of the first syllable), more difficulties in literacy (speed in reading and accuracy in writing) and certain correlations among competencies turning out to be different from the control group. In conclusion, our study established that a partially atypical trajectory emerged in preterms, showing specific long-term effects of preterm birth on language and literacy development.

This study aimed to investigate early lexical and grammatical development and their relations in a sample of very immature healthy preterms, in order to assess whether their linguistic development was typical, at risk or atypical. The effects of biological factors and parental level of education on preterms' linguistic development were also investigated. Seventy-three Italian preterms and 22 Italian fullterms (control sample) were assessed at 2;6 with an Italian test of repetition of sentences (TRF). Their mothers completed the Italian version of the MacArthur questionnaire (PVB). Our results showed that most of the preterm sample displayed a typical development, compared with the fullterms, with lexicon and grammar within the normal range and a normal relation between these competencies. However, preterms characterized by an extremely low birthweight (ELBW), a very low gestational age and male gender were at risk, with slight delays in the lexicon and grammar, but still retaining the normal relation between the two. (Contains 1 footnote.) [This research was supported by the University of Bologna.]

Abstract Background Respiratory Syncytial Virus (RSV) is the most important cause of severe respiratory infections in infants with seasonal epidemics. Environmental factors (temperature, humidity, air pollution) could influence RSV epidemics through their effects on virus activity and diffusion. Methods We conducted a retrospective study on a paediatric population who referred to our Paediatric Emergency Unit in order to analyze the correlation between weekly incidence of RSV positive cases during winter season in Bologna and meteorological factors and air pollutants concentration. Results We observed a significant correlation between the incidence of RSV infections and the mean minimum temperature registered during the same week and the previous weeks. The weekly number of RSV positive cases was also correlated to the mean PM10 concentration of the week before. Conclusions RSV epidemic trend in Bologna (Italy) is related to the mean minimum temperature, and the mean PM10 concentration.

Abstract A male infant born by caesarean section at 38 weeks of gestational age (B.W. 4055 g; Apgar 9-10), in the first two hours of life his right leg became hypovascularizated. Normal values of leukocities, red cells, haematocrit, hemoglobin, platelets. C-Reactive Protein negative. Electrolytes and coagulation tests were normal. Normal vitamin K coagulation proteins levels. Serological tests for TORCH (IgM) and Parvovirus (IgG and IgM) were negative. Sonography showed a reduced blood flow in the iliac artery and reported a 1 cm long vessel thrombosis. From 8 hours of life we administred an intravenous infusion of unfractionated heparin (UFH) 75 UI/Kg for the first 10 minutes then 28 UI/Kg/h. On the 2nd day tests were performed to assess absence of inhibiting-clot factors. The dosage of homocysteine, protein S and antithrombin was normal. FV Leiden and antiphospholipid antibodies were negative. The mapping of G20210A prothrombin's gene resulted normal, whereas the concentration of Protein C was lower than normal: activity 46% (68-150%), antigen 35% (70-150%). The same deficiency was also found in the father. The mother showed normal concentrations. No episodies of thrombosis events were documentated in the family. The intravenous unfractionated heparin (UFH) therapy was replaced after 64 hours by subcutaneous nadroparin 600 UI twice/day, which was stopped 5 days later when the vessel sonografic images were completely normal. During the hospitalization the infant didn't show bleeding. The child was followed-up yearly until 4 years of age: he was well and had a normal body and mental development. The final diagnosis is likely to be of a permanent protein C deficiency in heterozygous form. Our case is interesting because the first manifestation was an important thrombosis of large vessel that occurred within a few hours of life in absence of perinatal risk factors, as if it was a homozygous disease, but the patient had a heterozygotic form. In literature few cases are reported of heterozygous forms that became symptomatic, but only in old age. After a severe first manifestation, a normal and asymptomatic development is uncommon without new thrombotic episodes. In our patient the neonatal thrombosis was the sole event in his life.