Aim: To investigate neurodevelopmental outcome in 12-year-old children born very preterm in relation to perinatal, neonatal and socioeconomic variables. To examine whether previously described positive effects of antenatal steroids on cognition persist at 12 years.
Methods: Prospective cohort, 78 children with gestational ages 22.7-31.9 weeks, born in 2004-2007 and examined at 12 years of age with cognitive, motor and visual motor integration tasks and compared to an age-matched control group (n = 50). Two preterm subgroups were studied: very preterm children (28-31 gestational weeks, n = 53) and extremely preterm children (22-27 gestational weeks, n = 25).
Results: The preterm children had significantly lower scores on all cognitive, motor and visual motor integration tasks than the controls. Gestational age and maternal education influenced associations differently in the two preterm subgroups. Also, severe retinopathy of prematurity demonstrated strong associations to outcome. In the extremely preterm group, administration of antenatal steroids was associated with better cognition, basic attention, word generation and motor skills.
Conclusion: At 12 years of age, very preterm children born in the 2000s still have deficits across several neurodevelopmental domains compared to term-born peers. Administration of antenatal steroids has long-lasting associations to cognition and motor skills in extremely preterm-born children.
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http://dx.doi.org/10.1111/apa.16140 | DOI Listing |
Introduction: Antenatal corticosteroid (ACS) administration before anticipated preterm birth is one of the most important interventions available to improve neonatal outcomes. Nevertheless, this treatment is associated with an increased risk of neonatal hypoglycemia. The aim of this study was to determine whether preterm twins who receive ACS are at increased risk for developing neonatal hypoglycemia.
View Article and Find Full Text PDFJ Perinat Med
January 2025
Department of Obstetrics & Gynaecology, 2541 Monash University, Melbourne, VIC, Australia.
Introduction: Vasa previa (VP) is a serious pregnancy complication in which fetal vessels, unprotected by the umbilical cord, run across or within close proximity to the internal cervical os, which can potentially result in fetal exsanguination in the event of membrane rupture. There is global consensus that women with antenatally diagnosed VP should have caesarean delivery prior to onset of labour to prevent the catastrophic complications of VP. However, there is variability in the approach to management of these women antenatally, particularly regarding hospitalisation and timing of steroid administration and delivery.
View Article and Find Full Text PDFDiseases
December 2024
Department of Obstetrics and Gynecology and CERICSAL (Centro di Ricerca Clinico SALentino), "Veris delli Ponti Hospital", Via Giuseppina Delli Ponti, 73020 Scorrano, Lecce, Italy.
Background: The term "fetal programming" refers to the effects of endogenous and exogenous corticosteroids, whether received from the mother or the fetus, on brain development and the hypothalamic-pituitary-adrenal axis reset. The authors of this narrative review examine the WHO's guidelines for prenatal corticosteroids in pregnant women who are at high risk of premature delivery. These guidelines are regarded as the best available for preventing late-life problems resulting from preterm.
View Article and Find Full Text PDFJ Clin Res Pediatr Endocrinol
December 2024
Department of Pediatric Endocrinology, Marmara University, School of Medicine, Istanbul, Turkiye.
Signs of virilization, such as clitoromegaly, labio-scrotal fusion, and urogenital sinus may be observed in females with 21-hydroxylase deficiency (21-OHD) and other rare virilizing forms of congenital adrenal hyperplasia (CAH). This makes sex determination difficult, and multiple reconstructive surgeries in the postnatal period may be required. As 21-OHD is an autosomal recessive disease, the chance of any child being affected is one in four and so only one in eight will be an affected female.
View Article and Find Full Text PDFAm J Physiol Lung Cell Mol Physiol
December 2024
Department of Pediatrics, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA.
Intrauterine inflammation from chorioamnionitis (CA) is associated with placental dysfunction and increased risk of bronchopulmonary dysplasia (BPD), the chronic lung disease of prematurity. Antenatal steroid (ANS) treatment improves early respiratory outcomes for premature infants. However, it remains unclear whether ANS improve long-term respiratory outcomes, and whether these effects are mediated through improvement of placental dysfunction and/or direct impact on the fetal lung.
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