Browsing by Subject "LOW-BIRTH-WEIGHT"

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  • van der Valk, Ralf J. P.; Kreiner-Moller, Eskil; Kooijman, Marjolein N.; Guxens, Monica; Stergiakouli, Evangelia; Saaf, Annika; Bradfield, Jonathan P.; Geller, Frank; Hayes, M. Geoffrey; Cousminer, Diana L.; Koerner, Antje; Thiering, Elisabeth; Curtin, John A.; Myhre, Ronny; Huikari, Ville; Joro, Raimo; Kerkhof, Marjan; Warrington, Nicole M.; Pitkanen, Niina; Ntalla, Ioanna; Horikoshi, Momoko; Veijola, Riitta; Freathy, Rachel M.; Teo, Yik-Ying; Barton, Sheila J.; Evans, David M.; Kemp, John P.; St Pourcain, Beate; Ring, Susan M.; Smith, George Davey; Bergstrom, Anna; Kull, Inger; Hakonarson, Hakon; Mentch, Frank D.; Bisgaard, Hans; Chawes, Bo; Stokholm, Jakob; Waage, Johannes; Eriksen, Patrick; Sevelsted, Astrid; Melbye, Mads; van Duijn, Cornelia M.; Medina-Gomez, Carolina; Hofman, Albert; de Jongste, Johan C.; Taal, H. Rob; Eriksson, Johan; Palotie, Aarno; Knip, Mikael; Widen, Elisabeth; Early Genetics Lifecourse; Genetic Invest ANthropometric; Early Growth Genetics EGG (2015)
  • Heinonen, Kati; Räikkönen, Katri; Pesonen, Anu-Katriina; Andersson, Sture; Kajantie, Eero; Eriksson, Johan; Wolke, Dieter; Lano, Aulikki (2010)
  • Bonamy, Anna-Karin Edstedt; Mohlkert, Lilly-Ann; Hallberg, Jenny; Liuba, Petru; Fellman, Vineta; Domellof, Magnus; Norman, Mikael (2017)
    Background-Advances in perinatal medicine have increased infant survival after very preterm birth. Although this progress is welcome, there is increasing concern that preterm birth is an emerging risk factor for hypertension at young age, with implications for the lifetime risk of cardiovascular disease. Methods and Results-We measured casual blood pressures (BPs) in a population-based cohort of 6-year-old survivors of extremely preterm birth (<27 gestational weeks; n=171) and in age-and sex-matched controls born at term (n=172). Measured BP did not differ, but sex, age-, and height-adjusted median z scores were 0.14 SD higher (P=0.02) for systolic BP and 0.10 SD higher (P=0.01) for diastolic BP in children born extremely preterm than in controls. Among children born extremely preterm, shorter gestation, higher body mass index, and higher heart rate at follow-up were all independently associated with higher BP at 6 years of age, whereas preeclampsia, smoking in pregnancy, neonatal morbidity, and perinatal corticosteroid therapy were not. In multivariate regression analyses, systolic BP decreased by 0.10 SD (P=0.08) and diastolic BP by 0.09 SD (P=0.02) for each week-longer gestation. Conclusions-Six-year-old children born extremely preterm have normal but slightly higher BP than their peers born at term. Although this finding is reassuring for children born preterm and their families, follow-up at older age is warranted.
  • Paalanne, Marika; Vääräsmäki, Marja; Mustaniemi, Sanna; Tikanmäki, Marjaana; Wehkalampi, Karoliina; Matinolli, Hanna-Maria; Eriksson, Johan; Järvelin, Marjo-Riitta; Morin-Papunen, Laure; Kajantie, Eero (2021)
    Objective: It has been suggested that adverse early life exposures increase the risk of developing polycystic ovary syndrome (PCOS) in later life. We hypothesized that women born preterm would have more biochemical and clinical signs of PCOS than women born at term. Design: The ESTER Preterm Birth Study participants were born in Northern Finland and identified from the Northern Finland Birth Cohort and the Finnish Medical Birth Register. Altogether, 74 women born very or moderately preterm (= 37 weeks, controls) were included in the analysis (mean age: 23.2 years). Methods: We measured serum total testosterone and sex hormone-binding globulin (SHBG) and calculated the free androgen index (FAI). PCOS according to the clinical and biochemical signs was defined either as hirsutism and oligoamenorrhea (via questionnaire) or as oligoamenorrhea and elevated testosterone levels (>2.4 nmol/L). Results: Women born VMPT/LPT exhibited 33.0% (8.7, 62.8)/16.4% (-2.0, 38.1) higher testosterone, 28.5% (5.3, 45.9)/24.1% (5.6, 38.9) lower SHBG levels, and 64.6% (19.4, 127.1)/42.5% (11.1, 82.9) higher FAI than controls after adjusting for age and recruitment cohort, maternal BMI, smoking, and pregnancy disorders, parental education, history of hypertension, diabetes, myocardial infarction or stroke, and subject's birth weight s.D. Odds ratios for having PCOS were 1.67 (0.44, 6.23)/3.11 (1.26, 7.70). Conclusions: Women born preterm have a more hyperandrogenic hormonal profile, and those born LPT are approximately three times more likely at risk to have PCOS compared to women born at term.
  • Eriksson, Johan G. (2019)
    Type 2 diabetes (T2D) is a major, rapidly increasing global public health challenge. The major risk factors for T2D include overweight and obesity, lifestyle-related factors and genetic factors. Early life exposures shape the developmental trajectories and alter susceptibility to T2D. Based on epidemiological studies it has been suggested that fetal undernutrition plays a role in the etiology of T2D. A low birth weight has been considered a proxy for fetal undernutrition. A meta-analysis reported that a 1 kg increase in birth weight is associated with a roughly 20% lower risk of T2D. Although fetal life is of major importance for future health, the period spanning the first 1000 days of life, is characterized by great plasticity and largely influencing later health. Different growth trajectories during this time period have also been associated with an increased risk of T2D. Studies assessing the association between age at BMI rebound in childhood and later risk for T2D have reported a fivefold difference in T2D according to age at BMI rebound. Developmental and epidemiological cohort studies focusing on T2D have major public health implications supporting a paradigm shift; a shift from focusing upon risk factor modification in adult life to adopting a life course perspective when studying T2D. This paradigm shift will not only help us in getting a better understanding of the pathophysiology underlying T2D, but it will also open new possibilities and opportunities in the prevention of T2D and related disorders.
  • the PIPARI Study Group; Lahti, Katri; Saunavaara, Virva; Munck, Petriina; Uusitalo, Karoliina; Koivisto, Mari; Parkkola, Riitta; Haataja, Leena (2020)
    Abstract Aim Very preterm children born less than 32 weeks of gestation are at risk for motor difficulties such as cerebral palsy and developmental coordination disorder. This study explores the association between diffusion tensor imaging metrics at term and motor outcomes at 11 years of age. Methods A cohort of 37 very preterm infants (mean gestational age 29 4/7, SD 2 0/7) born in 2004-2006 in Turku University Hospital underwent diffusion tensor imaging at term. A region-of-interest analysis of fractional anisotropy and mean diffusivity was performed. Motor outcomes at 11 years of age were measured with the Movement Assessment Battery for Children ? Second Edition. Results The diffusion metrics of the corpus callosum (genu p=0.005, splenium p=0.049), the left corona radiata (p=0.035) and the right optic radiation (p=0.017) were related to later motor performance. Mean diffusivity decreased and fractional anisotropy increased in proportion to the improving performance. Conclusion The diffusion metrics of the genu and splenium of the corpus callosum, the left corona radiata and the right optic radiation at term were associated with motor skills at 11 years of age. Diffusion tensor imaging should be further studied as a potential tool in recognising children at risk for motor impairment.
  • Stolt, Suvi; Savini, Silvia; Guarini, Annalisa; Caselli, Maria Cristina; Matomäki, Jaakko; Lapinleimu, Helena; Haataja, Leena; Lehtonen, Liisa; Alessandroni, Rosina; Faldella, Giacomo; Sansavini, Alessandra (2017)
    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
  • Vehkavuori, Suvi-Maria; Stolt, Suvi (2019)
    Previous studies have shown that early lexical development is associated with later language development. It is less clear which language domains early receptive/expressive lexicons are associated with. This study analyses these associations. The study also investigates whether children with slow/typical/fast developing early receptive/expressive lexical skills differed in their language skills at three and a half years (42 months) and the predictive value of early receptive/expressive lexical skills for later language skills. The participants of this longitudinal study were 68 healthy, monolingual Finnish-speaking children whose language development was measured using the Finnish, short-form-version of the Communicative Development Inventories at 12, 15, 18 and 24 months. At 42 months, language skills of the participants were assessed using tests measuring lexical, phonological, morphological and general receptive/expressive language skills. Early receptive lexicon was associated with later morphological skills from 15 months and onwards and with other language domains at 24 months. Early expressive lexicon was associated with later morphological skills at 15 months and onwards but with other language domains from 18 months. A trend was found that children with different early lexical growth rates differed in their language skills at 42 months. The best models for predicting later receptive/expressive language skills included variables from both early receptive and expressive lexicons. These models worked well to explain receptive/expressive language skills at 42 months (63/78% of the variance). This study provides novel information on the specific associations between receptive and expressive lexicon growth and later language skills. For clinicians, measuring both receptive and expressive lexicons provides the most representative information on children's language development.
  • Hjort, Line; Moller, Sofie Lykke; Minja, Daniel; Msemo, Omari; Nielsen, Birgitte Bruun; Christensen, Dirk Lund; Theander, Thor; Nielsen, Karsten; Larsen, Lise Grupe; Grunnet, Louise Groth; Groop, Leif; Prasad, Rashmi; Lusingu, John; Schmiegelow, Christentze; Bygbjerg, Ib C. (2019)
    Purpose Low-income and middle-income countries such as Tanzania experience a high prevalence of noncommunicable diseases (NCDs), including anaemia. Studying if and how anaemia affects growth, placenta development, epigenetic patterns and newborns' risk of NCDs may provide approaches to prevent NCDs. Participants The FOETALforNCD (FOetal Exposure and Epidemiological Transitions: the role of Anaemia in early Life for Non-Communicable Diseases in later life) Study is a population-based preconception, pregnancy and birth cohort study (n= 1415, n= 538, n= 427, respectively), conducted in a rural region of North-East Tanzania. All participants were recruited prior to conception or early in pregnancy and followed throughout pregnancy as well as at birth. Data collection included: maternal blood, screening for NCDs and malaria, ultrasound in each trimester, neonatal anthropometry at birth and at 1 month of age, cord blood, placental and cord biopsies for stereology and epigenetic analyses. Findings to date At preconception, the average age, body mass index and blood pressure of the women were 28 years, 23 kg/m(2) and 117/75 mm Hg, respectively. In total, 458 (36.7%) women had anaemia (haemoglobin Hb <12 g/dL) and 34 (3.6%) women were HIV-positive at preconception. During pregnancy 359 (66.7%) women had anaemia of which 85 (15.8%) women had moderate-tosevere anaemia (Hb = 9 g/dL) and 33 (6.1%) women had severe anaemia (Hb = 8 g/dL). In total, 185 (34.4%) women were diagnosed with malaria during pregnancy. Future plans The project will provide new knowledge on how health, even before conception, might modify the risk of developing NCDs and how to promote better health during pregnancy. The present project ended data collection 1 month after giving birth, but follow-up is continuing through regular monitoring of growth and development and health events according to the National Road Map Strategic Plan in Tanzania. This data will link fetal adverse event to childhood development, and depending on further grant allocation, through a life course follow-up.
  • PIPARI Study Grp; Lind, Annika; Haataja, Leena; Laasonen, Marja; Saunavaara, Virva; Railo, Henry; Lehtonen, Tuomo; Vorobyev, Victor; Uusitalo, Karoliina; Lahti, Katri; Parkkola, Riitta (2021)
    Objectives: Impairments in visual perception are among the most common developmental difficulties related to being born prematurely, and they are often accompanied by problems in other developmental domains. Neural activation in participants born prematurely and full-term during tasks that assess several areas of visual perception has not been studied. To better understand the neural substrates of the visual perceptual impairments, we compared behavioral performance and brain activations during visual perception tasks in adolescents born very preterm (birth weight <= 1500 g or gestational age <32 weeks) and full-term. Methods: Tasks assessing visual closure, discrimination of a deviating figure, and discrimination of figure and ground from the Motor-Free Visual Perception Test, Third Edition were performed by participants born very preterm (n = 37) and full-term (n = 34) at 12 years of age during functional magnetic resonance imaging. Results: Behavioral performance in the visual perception tasks did not differ between the groups. However, during the visual closure task, brain activation was significantly stronger in the group born very preterm in a number of areas including the frontal, anterior cingulate, temporal, and posterior medial parietal/cingulate cortices, as well as in parts of the cerebellum, thalamus, and caudate nucleus. Conclusions: Differing activations during the visual closure task potentially reflect a compensatory neural process related to premature birth or lesser neural efficiency or may be a result of the use of compensatory behavioral strategies in the study group born very preterm.
  • Persson, Martina; Opdahl, Signe; Risnes, Kari; Gross, Raz; Kajantie, Eero; Reichenberg, Abraham; Gissler, Mika; Sandin, Sven (2020)
    Introduction The complex etiology of autism spectrum disorder (ASD) is still unresolved. Preterm birth ( Author summaryWhy was this study done? Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent impairments in social communication and restricted and repetitive behaviors. The etiology remains unresolved. Length of gestation, including preterm birth, has been linked to risk of ASD, but reliable estimates of risks for the whole range of gestational ages (GAs) are lacking. The primary objective of this study was to provide a detailed and robust description of ASD risk across the entire range of GA while taking fetal sex and size at birth into account. What did the researchers do and find? This study was based on population-based data from national medical registries in three Nordic countries-Sweden, Finland, and Norway-and included 3,526,174 singletons born 1995 to 2015. Relative risks (RRs) of ASD by GA at birth were estimated with log binominal regression. The RR of ASD increased by each week of GA, pre- as well as postterm, from 40 to 24 weeks of gestation and from 40 to 44 weeks of gestation, independently of sex and birth weight for GA. What do these findings mean? On a population level, the risks of ASD were increased in children born either pre- or postterm, including children born close to week 40. We found that the risk of ASD increased weekly, with each week further away from 40 weeks of gestation.
  • Karila, Kristiina; Anttila, Annaleena; Iber, Tarja; Pakarinen, Mikko; Koivusalo, Antti (2019)
    Background: Surgery for necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) is often complicated by intestinal failure (IF) and intestinal failure associated cholestasis (IFAC). Objective: Assessment of incidence, predictors, and mortality associated with IFAC in surgically treated NEC and SIP. Methods: A retrospective observational study based on hospital records during 1986-2014 in the two largest Finnish neonatal intensive care units was performed. IFAC was defined as conjugated bilirubin >34 mu mo1/1 (2.0 mg/dl) for >= two postoperative weeks while receiving parenteral nutrition (PN). Results: In total 225 patients underwent surgery for NEC (n 142; 63%) or SIP (n = 83; 37%). Included were 57 survivors with >= two weeks PN. Sixty-five (42%) patients developed IFAC. Two-year survival with IFAC was 80% and without IFAC 89% (p = 0.13). Of the 65 patients with IFAC, all eight with unresolved IFAC died in comparison to six of 57 (11%) whose IFAC resolved (p <0.0001), while IFAC resolved in all survivors. Survival among patients with resolved IFAC was 89% and with unresolved IFAC (n = 8) 0%, (p <0.0001).IFAC lasted for median 83 (IQR 45-120) days and correlated with the duration of PN (R2 = 0.16, p = 0.03), delay of starting enteral feeds (R2 = 0.12, p = 0.05) and PN lipid emulsion (RR = 1.0 (95% CI = 1.0-1.1) (p = 0.02). In multivariate logistic regression analysis, IFAC development associated with septicemias and reoperations. Conclusions: 42% of pre matures who underwent surgery for NEC or SIP developed IFAC. Reoperations and septicemias increased the risk of IFAC. None of the patients with unresolved IFAC survived, but IFAC did not increase overall mortality. Type of study: Retrospective prognosis study. (C) 2018 Elsevier Inc. All rights reserved.
  • Tikanmäki, Marjaana; Kaseva, Nina; Tammelin, Tuija; Sipola-Leppänen, Marika; Matinolli, Hanna-Maria; Eriksson, Johan G.; Järvelin, Marjo-Riitta; Vääräsmäki, Marja; Kajantie, Eero (2017)
    Objective To evaluate the amount of self-reported physical activity in young adults born prematurely compared with those born at term. Study design Unimpaired participants of the Preterm Birth Study (Preterm Birth and Early Life Programming of Adult Health and Disease) birth cohort study were studied at age 23.3 +/- 1.2 (SD) years: 118 born early preterm (= 37 weeks, controls). The participants completed a validated 30-item, 12-month physical activity questionnaire. The annual frequency and total volume of conditioning and nonconditioning leisure time physical activity and commuting physical activity were calculated and the data analyzed by means of linear regression. Results Adults born early preterm reported a 31.5% (95% CI, 17.4-43.2) lower volume of leisure time physical activity (in metabolic equivalents [MET] h/year) and had a 2.0-fold increased OR (1.2-3.3) of being in the least active quintile than controls. Lower amounts of conditioning, nonconditioning, and commuting physical activity all contributed to the difference. In addition, early preterm participants undertook less vigorous physical activity (>= 6 MET). No differences in physical activity were found between the late preterm and control groups. Adjustments for potential early life confounders and current mediating health characteristics did not change the results. Conclusions Young adults born early preterm engage less in leisure time physical activities than peers born at term. This finding may in part underlie the increased risk factors of cardiometabolic and other noncommunicable diseases in adults born preterm. Low physical activity is a risk factor for several noncommunicable diseases and amenable to prevention.
  • Näsänen-Gilmore, Pieta; Sipola-Leppänen, Marika; Tikanmäki, Marjaana; Matinolli, Hanna-Maria; Eriksson, Johan G.; Järvelin, Marjo-Riitta; Vääräsmäki, Marja; Hovi, Petteri; Kajantie, Eero (2018)
    Very preterm birth, before the gestational age (GA) of 32 weeks, increases the risk of obstructed airflow in adulthood. We examined whether all preterm births (GA= 37 weeks). Preterm birth was associated with poorer lung function. Mean differences between individuals born early preterm versus full-term were -0.23 standard deviation (SD) (95% confidence interval (CI): -0.40, -0.05)) for forced vital capacity z-score (zFVC), -0.44 SD (95% CI -0.64, -0.25) for forced expiratory volume z-score (zFEV1), and -0.29 SD (95% CI -0.47, -0.10) for zFEV1/FVC. For late preterm, mean differences with full-term controls were -0.02 SD (95% CI -0.17, 0.13), -0.12 SD (95% CI -0.29, 0.04) and -0.13 SD (95% CI -0.29, 0.02) for zFVC, zFEV1, and zFEV1/FVC, respectively. Examination of finer GA subgroups suggested an inverse non-linear association between lung function and GA, with the greatest impact on zFEV1 for those born extremely preterm. The subgroup means were GA= 37weeks): 0.02 SD. Corresponding means for zFEV1/FVC were -1.79, -0.44, -0.47, -0.48, -0.29, and -0.02. Adjustment for maternal pregnancy conditions and socioeconomic and lifestyle factors had no major impact on the relationship. Preterm birth is associated with airflow limitation in adult life. The association appears to be attributable predominantly to those born most immature, with only a modest decrease among those born preterm at later gestational ages.
  • Jaskari, Joel; Myllärinen, Janne; Leskinen, Markus; Rad, Ali Bahrami; Hollmen, Jaakko; Andersson, Sture; Särkkä, Simo (2020)
    Preterm birth is the leading cause of mortality in children under the age of five. In particular, low birth weight and low gestational age are associated with an increased risk of mortality. Preterm birth also increases the risks of several complications, which can increase the risk of death, or cause long-term morbidities with both individual and societal impacts. In this work, we use machine learning for prediction of neonatal mortality as well as neonatal morbidities of bronchopulmonary dysplasia, necrotizing enterocolitis, and retinopathy of prematurity, among very low birth weight infants. Our predictors include time series data and clinical variables collected at the neonatal intensive care unit of Children's Hospital, Helsinki University Hospital. We examine 9 different classifiers and present our main results in AUROC, similar to our previous studies, and in F1-score, which we propose for classifier selection in this study. We also investigate how the predictive performance of the classifiers evolves as the length of time series is increased, and examine the relative importance of different features using the random forest classifier, which we found to generally perform the best in all tasks. Our systematic study also involves different data preprocessing methods which can be used to improve classifier sensitivities. Our best classifier AUROC is 0.922 in the prediction of mortality, 0.899 in the prediction of bronchopulmonary dysplasia, 0.806 in the prediction of necrotizing enterocolitis, and 0.846 in the prediction of retinopathy of prematurity. Our best classifier F1-score is 0.493 in the prediction of mortality, 0.704 in the prediction of bronchopulmonary dysplasia, 0.215 in the prediction of necrotizing enterocolitis, and 0.368 in the prediction of retinopathy of prematurity.
  • Hatem, Gad; Hjort, Line; Asplund, Olof; Minja, Daniel T. R.; Msemo, Omari Abdul; Moller, Sofie Lykke; Lavstsen, Thomas; Groth-Grunnet, Louise; Lusingu, John P. A.; Hansson, Ola; Christensen, Dirk Lund; Vaag, Allan A.; Artner, Isabella; Theander, Thor; Groop, Leif; Schmiegelow, Christentze; Bygbjerg, Ib Christian; Prasad, Rashmi B. (2022)
    Context Anemia during early pregnancy (EP) is common in developing countries and is associated with adverse health consequences for both mothers and children. Offspring of women with EP anemia often have low birth weight, which increases risk for cardiometabolic diseases, including type 2 diabetes (T2D), later in life. Objective We aimed to elucidate mechanisms underlying developmental programming of adult cardiometabolic disease, including epigenetic and transcriptional alterations potentially detectable in umbilical cord blood (UCB) at time of birth. Methods We leveraged global transcriptome- and accompanying epigenome-wide changes in 48 UCB from newborns of EP anemic Tanzanian mothers and 50 controls to identify differentially expressed genes (DEGs) in UCB exposed to maternal EP anemia. DEGs were assessed for association with neonatal anthropometry and cord insulin levels. These genes were further studied in expression data from human fetal pancreas and adult islets to understand their role in beta-cell development and/or function. Results The expression of 137 genes was altered in UCB of newborns exposed to maternal EP anemia. These putative signatures of fetal programming, which included the birth weight locus LCORL, were potentially mediated by epigenetic changes in 27 genes and associated with neonatal anthropometry. Among the DEGs were P2RX7, PIK3C2B, and NUMBL, which potentially influence beta-cell development. Insulin levels were lower in EP anemia-exposed UCB, supporting the notion of developmental programming of pancreatic beta-cell dysfunction and subsequently increased risk of T2D in offspring of mothers with EP anemia. Conclusions Our data provide proof-of-concept on distinct transcriptional and epigenetic changes detectable in UCB from newborns exposed to maternal EP anemia.
  • Marchi, Viviana; Stevenson, Nathan; Koolen, Ninah; Mazziotti, Raffaele; Moscuzza, Francesca; Salvadori, Stefano; Pieri, Rossella; Ghirri, Paolo; Guzzetta, Andrea; Vanhatalo, Sampsa (2020)
    Early nutritional compromise after preterm birth is shown to affect long-term neurodevelopment, however, there has been a lack of early functional measures of nutritional effects. Recent progress in computational electroencephalography (EEG) analysis has provided means to measure the early maturation of cortical activity. Our study aimed to explore whether computational metrics of early sequential EEG recordings could reflect early nutritional care measured by energy and macronutrient intake in the first week of life. A higher energy or macronutrient intake was assumed to associate with improved development of the cortical activity. We analyzed multichannel EEG recorded at 32 weeks (32.4 ± 0.7) and 36 weeks (36.6 ± 0.9) of postmenstrual age in a cohort of 28 preterm infants born before 32 weeks of postmenstrual age (range: 24.3–32 weeks). We computed several quantitative EEG measures from epochs of quiet sleep (QS): (i) spectral power; (ii) continuity; (iii) interhemispheric synchrony, as well as (iv) the recently developed estimate of maturational age. Parenteral nutritional intake from day 1 to day 7 was monitored and clinical factors collected. Lower calories and carbohydrates were found to correlate with a higher reduction of spectral amplitude in the delta band. Lower protein amount associated with higher discontinuity. Both higher proteins and lipids intake correlated with a more developmental increase in interhemispheric synchrony as well as with better progress in the estimate of EEG maturational age (EMA). Our study shows that early nutritional balance after preterm birth may influence subsequent maturation of brain activity in a way that can be observed with several intuitively reasoned and transparent computational EEG metrics. Such measures could become early functional biomarkers that hold promise for benchmarking in the future development of therapeutic interventions.
  • Aho, Leena; Metsäranta, Marjo; Lönnberg, Piia; Wolford, Elina; Lano, Aulikki (2021)
    Objective: The aim of this study was to evaluate the ability of the neonatal neurobehavioral characteristics to act as an indicator for later neurodevelopment and neurocognitive performance. Methods: Sixty-six infants born extremely preterm ( Results: An optimal auditory orientation at term age was associated with better developmental quotients (DQ) in Personal-Social, and Hearing-Language GMDS subscale at 2 years (p < 0.05). An optimal visual alertness was associated with better Total (p < 0.01), Locomotor (p < 0.001), and Eye-Hand Coordination (p < 0.01) DQs at 2 years, and with sensorimotor function (p < 0.001) and social perception (p < 0.01) tests at 6.5 years. Conclusion: The neurobehavioral characteristics of newborns might serve as a precursor of social cognition skills and the HNNE behavior subscale offers a tool to identify infants at risk for later deficits in neurodevelopment and social cognition.
  • Karila, Kristiina; Anttila, Annaleena; Iber, Tarja; Pakarinen, Mikko; Koivusalo, Antti (2018)
    Background: Necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) are the most common abdominal surgical conditions in preemies. Associated mortality remains high and long periods of parenteral nutrition (PN) may be required. We assessed the developments in the outcomes of surgically treated NEC and SIP in the two largest Finnish neonatal intensive care units (NICU). Methods: Retrospective observational study based on hospital records during 1986-2014. Main outcome measures were three-month survival during 1986-2000 compared with 2001-2014 and predictors of mortality. Results: Included were 225 patients (NICU A 131 and NICU B 94) with NEC in 142 (63%) and SIP 83 (37%). The median birth weight (BW) (870 vs 900 g) and gestation age (GA) (27 vs 27 weeks, p = 0.96) were similar in NEC and SIP. Small intestine was affected in 85% of NEC and 76% of SIP patients (p = 0.12). In 5% of patients NEC was panintestinal. Median small intestinal loss was 25% in NEC and 4.0% in SIP (p <0.001). Ileocecal valve was resected in 29% of NEC and 14% of SIP patients (p = 0.01). Enterostomy was performed in 78% of patients and primary anastomosis in 18%; 4% died of extensive NEC without definitive surgery. Overall survival was 74% (NEC 73%, SIP 77%, p = 0.48; NICU A 82%, NICU B 65%, p = 0.003). From 1986-2000 to 2001-2014 overall survival increased from 69 to 81% (p = 0.04). Treating NICU was the strongest predictor of survival, RR = 2.8 (95% CI = 1.4-5.1), p = 0.003. Conclusions: Overall survival improved significantly from the early (1986-2000) to the late (2001-2014) study period. Strongest predictor of mortality was the treating neonatal intensive care unit. (c) 2018 Elsevier Inc. All rights reserved.
  • Svedenkrans, Jenny; Ekblom, Örjan; Domellöf, Magnus; Fellman, Vineta; Norman, Mikael; Bohlin, Kajsa (2020)
    Physical activity (PA) can prevent cardiovascular diseases. Because of increased risks of impairments affecting motor activity, PA in children born preterm may differ from that in children born at term. In this prospective cohort study, we compared objectively measured PA in 71 children born extremely preterm (