Browsing by Subject "Newborn"

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  • Thiede, Anja; Virtala, Paula; Ala-Kurikka, Iina; Partanen, Eino; Huotilainen, Minna; Mikkola, Kaija; Leppänen, Paavo HT; Kujala, Teija (2019)
    Objective: Identifying early signs of developmental dyslexia, associated with deficient speech-sound processing, is paramount to establish early interventions. We aimed to find early speech-sound processing deficiencies in dyslexia, expecting diminished and atypically lateralized event-related potentials (ERP) and mismatch responses (MMR) in newborns at dyslexia risk. Methods: ERPs were recorded to a pseudoword and its variants (vowel-duration, vowel-identity, and syllable-frequency changes) from 88 newborns at high or no familial risk. The response significance was tested, and group, laterality, and frontality effects were assessed with repeated-measures ANOVA. Results: An early positive and right-lateralized ERP component was elicited by standard pseudowords in both groups, the response amplitude not differing between groups. Early negative MMRs were absent in the at-risk group, and MMRs to duration changes diminished compared to controls. MMRs to vowel changes had significant laterality x group interactions resulting from right-lateralized MMRs in controls. Conclusions: The MMRs of high-risk infants were absent or diminished, and morphologically atypical, suggesting atypical neural speech-sound discrimination. Significance: This atypical neural basis for speech discrimination may contribute to impaired language development, potentially leading to future reading problems. (C) 2019 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.
  • Olkkonen, Laura (Helsingin yliopisto, 2018)
    Tausta: Huumeiden käyttö raskauden aikana on riski sekä äidille että sikiölle. Raskaudenaikaisella opioidikorvaushoidolla pyritään suojelemaan äitiä ja lasta katuhuumeiden ja opioidien suonensisäisen käytön vaaroilta. Suomessa raskaudenaikaisena opioidikorvaushoitovalmisteena on käytetty metadonia tai buprenorfiinia, mutta viime aikoina myös buprenorfiini-naloksoniyhdistelmävalmistetta. Buprenorfiini-naloksoniyhdistelmävalmisteen vaikutuksesta äidin ja vastasyntyneen lapsen terveyteen on niukasti julkaistua tutkimustietoa, mutta haittoja käyttöön liittyen ei ole kuvattu. Menetelmät: Tutkimuksessa kerättiin potilasasiakirjoista raskaus-, synnytys- ja syntymätietoja kahdeksasta vuonna 2013 buprenorfiinikorvaushoidossa ja kahdeksasta vuonna 2014 buprenorfiini-naloksonikorvaushoidossa olleesta naisesta ja heidän vastasyntyneistä lapsistaan. Potilasasiakirjoista kerättiin seuraavat tulosmuuttujat: synnytystapa, mahdolliset raskauskomplikaatiot, raskauden kesto, synnytyksen kesto, vastasyntyneen Apgar-pisteet viiden minuutin iässä, napavaltimoverinäytteen pH ja emäsylimäärä, syntymäpaino, syntymäpituus, päänympärys, Finneganin pisteiden korkein arvo ja vieroitusoireiden lääkehoidon kesto. Tulokset: Buprenorfiini- ja buprenorfiini-naloksoniryhmän välillä ei ollut tilastollisesti merkitseviä eroavaisuuksia raskauden tai synnytyksen kestossa, keisarileikkausten esiintyvyydessä, Apgar-pisteissä, napavaltimon pH:ssa tai emäsylimäärässä, vastasyntyneen painossa, pituudessa tai päänympäryksessä, Finneganin pisteissä tai vieroitusoireiden lääkehoidon esiintyvyydessä tai kestossa. Buprenorfiiniryhmässä esiintyi huomattavasti enemmän raskauskomplikaatioita (raskausdiabetes, raskaudenajan maksahäiriö, ennenaikainen vedenmeno, verinen vuoto, sikiökuolema) kuin buprenorfiini-naloksoniryhmässä. Yksittäisten raskauskomplikaatioiden esiintyvyydessä ei kuitenkaan ollut tilastollisesti merkitsevää eroa. Pohdinta: Tässä pienessä aineistossa vaikuttaa siltä, että buprenorfiini-naloksoni ei olisi buprenorfiinia huonompi opioidikorvaushoitovalmiste raskauden aikana. Buprenorfiinikorvaushoitoon liittyi enemmän raskauskomplikaatioita. Tuloksia tulkittaessa on tutkimusaineiston pieni koko kuitenkin huomioitava.
  • Yeung, Edwina H.; Guan, Weihua; Zeng, Xuehuo; Salas, Lucas A.; Mumford, Sunni L.; de Prado Bert, Paula; van Meel, Evelien R.; Malmberg, Anni; Sunyer, Jordi; Duijts, Liesbeth; Felix, Janine F.; Czamara, Darina; Hämäläinen, Esa; Binder, Elisabeth B.; Räikkönen, Katri; Lahti, Jari; London, Stephanie J.; Silver, Robert M.; Schisterman, Enrique F. (2020)
    Background Prenatal inflammation has been proposed as an important mediating factor in several adverse pregnancy outcomes. C-reactive protein (CRP) is an inflammatory cytokine easily measured in blood. It has clinical value due to its reliability as a biomarker for systemic inflammation and can indicate cellular injury and disease severity. Elevated levels of CRP in adulthood are associated with alterations in DNA methylation. However, no studies have prospectively investigated the relationship between maternal CRP levels and newborn DNA methylation measured by microarray in cord blood with reasonable epigenome-wide coverage. Importantly, the timing of inflammation exposure during pregnancy may also result in different effects. Thus, our objective was to evaluate this prospective association of CRP levels measured during multiple periods of pregnancy and in cord blood at delivery which was available in one cohort (i.e., Effects of Aspirin in Gestation and Reproduction trial), and also to conduct a meta-analysis with available data at one point in pregnancy from three other cohorts from the Pregnancy And Childhood Epigenetics consortium (PACE). Secondarily, the impact of maternal randomization to low dose aspirin prior to pregnancy on methylation was assessed. Results Maternal CRP levels were not associated with newborn DNA methylation regardless of gestational age of measurement (i.e., CRP at approximately 8, 20, and 36 weeks among 358 newborns in EAGeR). There also was no association in the meta-analyses (all p > 0.5) with a larger sample size (n = 1603) from all participating PACE cohorts with available CRP data from first trimester (<18 weeks gestation). Randomization to aspirin was not associated with DNA methylation. On the other hand, newborn CRP levels were significantly associated with DNA methylation in the EAGeR trial, with 33 CpGs identified (FDR corrected p <0.05) when both CRP and methylation were measured at the same time point in cord blood. The top 7 CpGs most strongly associated with CRP resided in inflammation and vascular-related genes. Conclusions Maternal CRP levels measured during each trimester were not associated with cord blood DNA methylation. Rather, DNA methylation was associated with CRP levels measured in cord blood, particularly in gene regions predominately associated with angiogenic and inflammatory pathways.
  • Yeung, Edwina H; Guan, Weihua; Zeng, Xuehuo; Salas, Lucas A; Mumford, Sunni L; de Prado Bert, Paula; van Meel, Evelien R; Malmberg, Anni; Sunyer, Jordi; Duijts, Liesbeth; Felix, Janine F; Czamara, Darina; Hämäläinen, Esa; Binder, Elisabeth B; Räikkönen, Katri; Lahti, Jari; London, Stephanie J; Silver, Robert M; Schisterman, Enrique F (BioMed Central, 2020)
    Abstract Background Prenatal inflammation has been proposed as an important mediating factor in several adverse pregnancy outcomes. C-reactive protein (CRP) is an inflammatory cytokine easily measured in blood. It has clinical value due to its reliability as a biomarker for systemic inflammation and can indicate cellular injury and disease severity. Elevated levels of CRP in adulthood are associated with alterations in DNA methylation. However, no studies have prospectively investigated the relationship between maternal CRP levels and newborn DNA methylation measured by microarray in cord blood with reasonable epigenome-wide coverage. Importantly, the timing of inflammation exposure during pregnancy may also result in different effects. Thus, our objective was to evaluate this prospective association of CRP levels measured during multiple periods of pregnancy and in cord blood at delivery which was available in one cohort (i.e., Effects of Aspirin in Gestation and Reproduction trial), and also to conduct a meta-analysis with available data at one point in pregnancy from three other cohorts from the Pregnancy And Childhood Epigenetics consortium (PACE). Secondarily, the impact of maternal randomization to low dose aspirin prior to pregnancy on methylation was assessed. Results Maternal CRP levels were not associated with newborn DNA methylation regardless of gestational age of measurement (i.e., CRP at approximately 8, 20, and 36 weeks among 358 newborns in EAGeR). There also was no association in the meta-analyses (all p > 0.5) with a larger sample size (n = 1603) from all participating PACE cohorts with available CRP data from first trimester (< 18 weeks gestation). Randomization to aspirin was not associated with DNA methylation. On the other hand, newborn CRP levels were significantly associated with DNA methylation in the EAGeR trial, with 33 CpGs identified (FDR corrected p < 0.05) when both CRP and methylation were measured at the same time point in cord blood. The top 7 CpGs most strongly associated with CRP resided in inflammation and vascular-related genes. Conclusions Maternal CRP levels measured during each trimester were not associated with cord blood DNA methylation. Rather, DNA methylation was associated with CRP levels measured in cord blood, particularly in gene regions predominately associated with angiogenic and inflammatory pathways. Trial registration Clinicaltrials.gov, NCT00467363, Registered April 30, 2007, http://www.clinicaltrials.gov/ct2/show/NCT00467363
  • Nevalainen, P.; Marchi, V.; Metsäranta, M.; Lönnqvist, T.; Vanhatalo, S.; Lauronen, L. (2018)
    Objective: To evaluate the reliability of recording cortical somatosensory evoked potentials (SEPs) in asphyxiated newborns using the 4-electrode setup applied in routine long-term amplitude-integrated EEG (aEEG) brain monitoring and to assess the number of averages needed for reliably detecting the cortical responses. Methods: We evaluated median nerve SEPs in 50 asphyxiated full-term newborns. The SEP interpretation (present or absent) from the original recordings with 21-electrodes and approximately 600 trials served as the reference. This was compared to SEP classification (absent, present, or unreliable) based on a reduced (300 or 150) number of averages, and to classification based on only four electrodes (F3, P3, F4, P4). Results: Compared to the original classification, cortical SEPs were uniformly interpreted as present or absent in all 50 newborns with the 4-electrode setup and 600 averages. Reducing number of averages to 300 still resulted in correct SEP interpretation in 49/50 newborns with 21-electrode setup, and 46/50 newborns with 4-electrode setup. Conclusions: Evaluation of early cortical neonatal SEPs is reliable from the 4-electrode setup commonly used in aEEG monitoring. SEP is discernible in most newborns with 300 averages. Significance: Adding SEP into routine aEEG monitoring offers an additional tool for early neonatal neurophysiological evaluation. © 2018 International Federation of Clinical Neurophysiology
  • Nevalainen, Päivi; Marchi, Viviana; Metsäranta, Marjo; Lönnqvist, Tuula; Toiviainen-Salo, Sanna; Vanhatalo, Sampsa; Lauronen, Leena (2017)
    Objective: To evaluate the added value of somatosensory (SEPs) and visual evoked potentials (VEPs) recorded simultaneously with routine EEG in early outcome prediction of newborns with hypoxicischemic encephalopathy under modern intensive care. Methods: We simultaneously recorded multichannel EEG, median nerve SEPs, and flash VEPs during the first few postnatal days in 50 term newborns with hypoxic-ischemic encephalopathy. EEG background was scored into five grades and the worst two grades were considered to indicate poor cerebral recovery. Evoked potentials were classified as absent or present. Clinical outcome was determined from the medical records at a median age of 21 months. Unfavorable outcome included cerebral palsy, severe mental retardation, severe epilepsy, or death. Results: The accuracy of outcome prediction was 98% with SEPs compared to 90% with EEG. EEG alone always predicted unfavorable outcome when it was inactive (n = 9), and favorable outcome when it was normal or only mildly abnormal (n = 17). However, newborns with moderate or severe EEG background abnormality could have either favorable or unfavorable outcome, which was correctly predicted by SEP in all but one newborn (accuracy in this subgroup 96%). Absent VEPs were always associated with an inactive EEG, and an unfavorable outcome. However, presence of VEPs did not guarantee a favorable outcome. Conclusions: SEPs accurately predict clinical outcomes in newborns with hypoxic-ischemic encephalopathy and improve the EEG-based prediction particularly in those newborns with severely or moderately abnormal EEG findings. Significance: SEPs should be added to routine EEG recordings for early bedside assessment of newborns with hypoxic-ischemic encephalopathy. (C) 2017 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
  • Kupiainen, Johanna (Helsingfors universitet, 2010)
    Tutkielman lähtökohtana oli kerätä tietoja ennenaikaisista ja täysaikaisista vastasyntyneistä ja selvittää pienten keskosten osalta mahdollisia hoitokäytäntöjen muutoksia. Aineisto kerättiin kaikista vastasyntyneiden teho-osastolle kahden puolen vuoden mittaisen seurantajakson aikana hoitoon tulleista potilaista. Tiedot kerättiin 502 vastasyntyneestä. Tuloksia tarkasteltiin jakamalla vastasyntyneet raskausviikkojen perusteella raskausviikkoryhmiin ( alle 28, 28-31+6, 32-36+6 ja yli 37-viikkoiset ). Teho-osastolla hoidossa olleista lapsista 29 % oli pieniä keskosia, 34% lievästi ennenaikaisia ja 37 % täysiaikaisia. Suurin osa, noin 80 % teho-osastolle tulleista vastasynty neistä syntyi Naistenklinikalla. Hoitokäytönnöissä havaittiin muutoksia erittäin epäkypsien keskosten (alle 28-viikkoiset) kohdalla. Hengityskonehoidon kesto oli hieman lyhyempi vuoden 2008 keräysjaksolla, sama koski tehohoidon kestoa. Näiden keskosten vähäinen lukumäärä kuitenkin vaikeutti johtopäätösten tekoa. Vaikeiden hengitysvaikeuksien hoidossa kortikosteroidien käytössä siirryttiin deksametasonista hydrokortisoniin. Muiden keskosten hoidossa alkuhoidossa hieman useampi vastasyntynyt intuboitiin vuonna 2008 kuin vuonna 2007. Tämä näkyi myös surfaktantin käytön lisääntymisenä. Hengityskone- tai ylipainehoidon komplikaationa syntyneitä ilmavuotoja havaittiin eniten täysiaikaisilla vastasyntyneillä. Vastasyntyneiden teho-osaston potilaiden tärkein diagnoosi oli hengityselimistön sairaus.
  • El Moutacim, Yasmin (Helsingin yliopisto, 2017)
    Målet för denna avhandling är att undersöka på vilket sätt tidigt och senare diagnostiserad graviditetsdiabetes (GDM) påverkar barnets hälsa. Tillväxtrelaterade parametrar såsom vikt, ponderalindex, huvudomkrets och placentans vikt har studerats liksom även gestationsålder samt Apgar-poäng. Ytterligare har vi studerat skillnader hos mödrarna med graviditetsdiabetes. Materialet som användes i studien har insamlats för The Finnish Gestational Diabetes Prevention Study (RADIEL), ett randomiserat livsstilsinterventionsprojekt för kvinnor i riskgruppen för graviditetsdiabetes. Information om kvinnorna samlades i huvudsak in via blodprov, kostdagböcker och frågeformulär. Information gällande förlossningarna och barnen samlades in via patientjournaler. Studien påvisade att de kvinnorna som insjuknar i tidig GDM har en svårare sjukdomsbild och att de pojkar som föds till kvinnor med tidig GDM har en större vikt och ponderalindex än de som föds till en kvinna med sen GDM. Däremot påverkades flickors tillväxt i större mån av senare diagnostiserad GDM. Ytterligare kunde vi konstatera att flickfostrens vikt påverkas i större mån av GDM än pojkarnas. Denna studie påvisar att graviditetsdiabetes har en effekt på fostret trots att utfallen sällan är dramatiska, och att effekten är av olika grad beroende på fostrets kön. Därmed väcker studien frågan huruvida man i högre grad borde satsa resurser på uppföljning av och livsstilsinterventioner för gravida kvinnor i riskgruppen för GDM och särskilt för dem med flickfoster.
  • Videman, Mari; Stjerna, Susanna; Wikstrom, Valtteri; Nybo, Taina; Roivainen, Reina; Vanhatalo, Sampsa; Huotilainen, Minna; Gaily, Eija (2019)
    Introduction: Prenatal exposure to antiepileptic drugs (AEDs) is associated with developmental compromises in verbal intelligence and social skills in childhood. Our aim was to evaluate whether a multifeature Mismatch Negativity (MMN) paradigm assessing semantic and emotional components of linguistic and emotional processing would be useful to detect possible alterations in early auditory processing of newborns with prenatal AED exposure. Material and methods: Data on AED exposure. pregnancy outcome, neuropsychological evaluation of the mothers, information on maternal epilepsy type, and a structured neurological examination of the newborn were collected prospectively. Blinded to AED exposure, we compared a cohort of 36 AED-exposed with 46 control newborns at the age of two weeks by measuring MMN with a multifeature paradigm with six linguistically relevant deviant sounds and three emotionally uttered sounds. Results: Frontal responses for the emotionally uttered stimulus Happy differed significantly in the exposed newborns compared with the control newborns. In addition, responses to sounds with or without emotional component differed in newborns exposed to multiple AEDs compared with control newborns or to newborns exposed to only one AED. Conclusions: These preliminary findings suggest that prenatal AED exposure may alter early processing of emotionally and linguistically relevant sound information. (C) 2019 Elsevier Inc. All rights reserved.
  • Pelkonen, Tuula; Urtti, Suvi; Cardoso, Ondina; Kyaw, Moe H.; Roine, Irmeli; Peltola, Heikki (2021)
    Background Yearly, about two million infants die during the first 28 days of life. Most of these deaths occur in sub-Saharan Africa and a third of those are caused by severe infections. The early identification of infants at risk of death is important when trying to prevent poor outcomes. Objective The aim of this study was to identify risk factors for death among young infants with possible serious bacterial infection (pSBI) at hospital admission. Methods This prospective, observational, single-site, descriptive study forms part of a larger study on bacterial meningitis in infants