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Aim: To study cognitive function at 10y of age in a cohort of children who required neonatal intensive care within the Uppsala Neonatal Follow-up Study.Methods: 226 children, who were born in 1986-1989 and had required neonatal intensive care (NIC) and 72 full-term, healthy control children were enrolled in the study. NIC children were grouped according to gestational age (group I, 23-31 wk; subgroup IA, 23-27 wk; IB 28-31 wk; group II, 32-36 wk; group III, > 36 wk), with infants with congenital malformation (IWCM) included and excluded from the main groups. The Kaufman Assessment Battery for Children (K-ABC) was administered and results were analysed in relation to the K-ABC global scales: sequential, simultaneous, mental processing composite and achievement.Results: The great majority of children had well-developed cognitive function, reaching scores at an average level or above. When groups were compared, full-term children that required NIC (group III) showed lower scores than controls on all scales measured by the K-ABC. Preterm children from all the studied groups (groups IA, IB, II) showed poorer performance than controls in the simultaneous processing scale, and group IA scored lower than controls in the achievement scale. The incidence of major cognitive impairment (IQ < 70) was low in NIC children (< 5%), but children from group IA showed significant higher frequency of impairment in the simultaneous, mental processing composite and achievement scales. Children from group IA presented a high frequency of discrepancy between the K-ABC scales, with lower simultaneous and higher sequential scores. Analysis with IWCM excluded from the main groups revealed identical results.Conclusion: Most children who needed neonatal intensive care had developed well their cognitive function at 10 y of age. The long-term effect of neonatal intensive care on cognitive function was more evident in extremely preterm infants (group IA), especially in tasks involving simultaneous ways of processing information. [ABSTRACT FROM AUTHOR]

We provide descriptive data on women who delivered at 23–25 wk of gestation, and to relate foetal and neonatal outcomes to maternal factors, obstetric management and the principal reasons for preterm birth. Medical records of all women who had delivered in two tertiary care centres in 1992–1998 were reviewed. At the two centres, policies of active perinatal and neonatal management were universally applied. Logistic regression models were used to identify prenatal factors associated with survival. Of 197 women who delivered at 23–25 wk, 65% had experienced a previous miscarriage, 15% a previous stillbirth and 12% a neonatal death. The current pregnancy was the result of artificial reproduction in 13% of the women. In 71%, the pregnancy was complicated either by pre-eclampsia, chorioamnionitis, placental abruption or premature rupture of membranes. Antenatal steroids were given in 63%. Delivery was by caesarean section in 47%. The reasons for preterm birth were idiopathic preterm labour in 36%, premature rupture of membranes in 41% and physician-indicated deliveries in 23% of the mothers. Demographic details, use of antenatal steroids, caesarean section delivery and birthweight differed between mothers depending on the reason for preterm delivery. Of 224 infants, 5% were stillbirths and 63% survived to discharge. On multivariate logistic regression analysis comprising prenatally known variables, reasons for preterm birth were not associated with survival. Advanced gestational duration (OR: 2.43 per wk; 95% CI: 1.59–3.74), administration of any antenatal steroids (OR: 2.21; 95% CI: 1.14–4.28) and intrauterine referral from a peripheral hospital (OR: 2.93; 95% CI: 1.5–5.73) were associated with survival. Women who deliver at 23–25 wk comprise a risk group characterized by a high risk of reproductive failure and pregnancy complications. Survival rates were similar regardless of the reason for preterm birth. Policies of active perinatal management virtually eliminated intrapartum stillbirths. [ABSTRACT FROM AUTHOR]

Ten newborn infants, born at 25-41 wk of gestation and nursed in a neonatal intensive care unit or in a neonatal intermediate care unit, underwent monitoring of heart and respiratory rates with a new technique using an optical sensor, 0-60 d postnatally. The aim of this study was to compare the heart and respiratory rates recorded in infants by photoplethysmography with a probe positioned on three monitoring sites, namely the leg, buttock and interscapular region, with the rates recorded by ECG and transthoracic impedance, respectively. The recordings were compared in order to determine which individual heart beats and respiratory cycles were recorded with one or both relevant techniques. A high degree of association (r =0.99) was found between the respiratory rates recorded by photoplethysmography and by transthoracic impedance. Recordings of heart rates by ECG were also highly associated with the photoplethysmographic rates as measured at two (r = 0.99) of the three monitoring sites. It is concluded that heart and respiratory rates in infants can be monitored satisfactorily by the new method based on photoplethysmography. This method offers the advantage of recording several physiological parameters non-invasively with a single probe during the neonatal period. [ABSTRACT FROM AUTHOR]

Speech and language skills at 6.5 y of age were studied in a follow-up of a cohort of children who had required neonatal intensive care (NIC) at Uppsala University Children's Hospital. An interview with the parents indicated that preterm and full-term NIC children were older than control children when they reached certain stages in language development (short sentences, intelligible speech). Absence of babbling was more common in NIC children born at 23-27 wk than in other preterm NIC children, and occurrence of stuttering was more commonly noticed in preterm NIC children born at 23-27 wk than in those born at ≥32 wk and controls. [ABSTRACT FROM AUTHOR]

Linguistic skills at 6½ y of age were examined in a cohort of 284 children requiring neonatal intensive care (NIC) and in 40 controls. Ten linguistic areas were assessed. The results are presented for gestational age groups. The 10th percentile score of the controls was identified in each linguistic area. Seventy percent of the controls and <27% of the NIC children had no score lower than the 10th percentile score. Scores lower than the 10th percentile score were more common in NIC children born at term or at 23-31 wk, and within the latter group in those born at 28-31 wk, than in those born at 32-36 wk gestational age. The linguistic areas of auditory discrimination, imitation of articulatory positions and imitation of sentences were most frequently affected. NIC children born at 32-36 wk performed better in the last two areas than those born at <32 wk. To be a twin and born at 28-31 wk was associated with an increased risk of having more than five scores lower than the 10th percentile score of the controls. [ABSTRACT FROM AUTHOR]

Focuses on the language problems in children at risk neonatally. Complexity of linguistic skills; Differences on the linguistic skills of neonatal intensive care (NIC) children; Emphasis on different reasons for NIC in preterm and full-term infants.

Examines the linguistic skill at six and a half years of age in children requiring neonatal intensive care from 1986 to 1989. Assessment of linguistic areas; Identification of the percentile score of controls; Association between linguistic skills and heredity for speech and language.

Examines the aspects of spontaneous speech at 6 1/2 years of age in children requiring neonatal intensive care in 1986-1989. Deviations in prosody and poor facial expressions accompanying spontaneous speech; Assessment of spontaneous speech in children needing neonatal intensive care; Characteristics of children with spontaneous speech.