Search

Aim: To investigate how the aetiology of very preterm birth/very low birth weight is associated with mortality and later neurodevelopmental outcomes. Methods: Very preterm/very low‐birth weight singletons were categorised based on the aetiology of preterm birth: spontaneous preterm birth (n = 47, 28.1%), preterm premature rupture of membranes (n = 56, 33.5%) or placental vascular pathology (n = 64, 38.3%). Mortality, cerebral palsy, severe cognitive impairment by 11 years of age (<2SD) and mean full‐scale intelligence quotient at 11 years were studied in association with birth aetiology. Results: There was no difference in mortality or rate of cerebral palsy according to birth aetiologies. The rate of severe cognitive impairment was lower (4.9% vs. 15.3%) in the preterm premature rupture of the membrane group in comparison to the placental vascular pathology group (OR 0.2, 95% CI 0.03–0.9, adjusted for gestational age). At 11 years, there was no statistically significant difference in the mean full‐scale intelligence quotient. Conclusion: Placental vascular pathology, as the aetiology of very preterm birth/very low birth weight, is associated with a higher rate of severe cognitive impairments in comparison to preterm premature rupture of membranes, although there was no difference in the mean full‐scale intelligence quotient at 11 years. The aetiology of very preterm birth/very low birth weight was not associated with mortality or the rate of cerebral palsy. [ABSTRACT FROM AUTHOR]

Background: Preterm infants have a risk of health and developmental problems emerging after discharge. This indicates the need for a comprehensive follow-up to enable early identification of these problems. In this paper, we introduce a follow-up tool "ePIPARI – web-based follow-up for preterm infants". Our future aim is to investigate whether ePIPARI is a feasible tool in the follow-up of preterm infants and whether it can identify children and parents in need of clinical interventions. Methods: ePIPARI includes eight assessment points (at term age and at 1, 2, 4, 8, 12, 18, and 24 months of corrected age) when the child´s health and growth, eating and feeding, neurodevelopment, and parental well-being are evaluated. ePIPARI consists of several widely used, standardized questionnaires, in addition to questions typically presented to parents in clinical follow-up visits. It also provides video guidance and written information about age-appropriate neurodevelopment for the parents. Parents of children born before 34 weeks of gestation during years 2019–2022 are being invited to participate in the ePIPARI study, in which web-based follow-up with ePIPARI is compared to clinical follow-up. In addition, the parents of children born before 32 weeks of gestation, who reached the corrected age of two years during 2019–2021 were invited to participate for the assessment point of 24 months of ePIPARI. The parents are asked to fill in the online questionnaires two weeks prior to each clinical follow-up visit. Discussion: The web-based tool, ePIPARI, was developed to acquire a sensitive and specific tool to detect infants and parents in need of further support and clinical interventions. This tool could allow individualized adjustments of the frequency and content of the clinical visits. Trial registration: ClinicalTrials.cov, NCT05238168. Registered 11 April 2022 – Retrospectively registered. [ABSTRACT FROM AUTHOR]

Aim: To study the prognostic value of volumetric brain magnetic resonance imaging (MRI) at term equivalent age (TEA) and neurological examinations at TEA and at 2 years of corrected age for long-term neuromotor outcome in infants born very preterm.Method: A total of 98 infants born very preterm were included. Structural and volumetric brain MRI and the Dubowitz neurologic examination were done at TEA. The Hammersmith Infant Neurological Examination (HINE) was performed at 2 years of corrected age. The Touwen examination was used for the assessment of minor neurological dysfunction (MND) at the age of 11 years.Results: Of all children (median birthweight 1083g [quartiles 820, 1300]; gestational age 28 5/7wks [26 4/7, 30 2/7]), 41 had simple MND, 11 had complex MND (cMND), and eight had cerebral palsy (CP). The negative and positive predictive value of structural brain MRI for cMND or CP was 88% and 50% respectively. Reduced volumes of total brain tissue, frontal lobes, basal ganglia and thalami, and cerebellum associated with cMND or CP. The results of the Dubowitz neurologic examination and the HINE correlated with the Touwen examination.Interpretation: Structural and volumetric MRI at TEA and structured neurological examinations predict long-term neuromotor outcome in infants born preterm. [ABSTRACT FROM AUTHOR]