Browsing by Subject "PRETERM INFANTS"

Sort by: Order: Results:

Now showing items 1-15 of 15
  • Huusko, Johanna M.; Karjalainen, Minna K.; Mahlman, Mari; Haataja, Ritva; Kari, M. Anneli; Andersson, Sture; Toldi, Gergely; Tammela, Outi; Ramet, Mika; Lavoie, Pascal M.; Hallman, Mikko (2014)
  • Korkalainen, Noora; Mäkikallio, Timo; Räsänen, Juha; Huikuri, Heikki; Mäkikallio, Kaarin (2021)
    Background: According to epidemiological studies, impaired intrauterine growth increases the risk for cardiovascular morbidity and mortality in adulthood. Heart rate variability (HRV), which reflects the autonomic nervous system function, has been used for risk assessment in adults while its dysfunction has been linked to poor cardiovascular outcome. Objective: We hypothesized that children who were born with fetal growth restriction (FGR) and antenatal blood flow redistribution have decreased HRV at early school age compared to their gestational age matched peers with normal intrauterine growth. Study design: A prospectively collected cohort of children born with FGR (birth weight = -2SD. Conclusions: Early school age children born with FGR and intrauterine blood flow redistribution demonstrated altered heart rate variability. These prenatal and postnatal findings may be helpful in targeting preventive cardiovascular measures in FGR.
  • Koolen, Ninah; Oberdorfer, Lisa; Rona, Zsofia; Giordano, Vito; Werther, Tobias; Klebermass-Schrehof, Katrin; Stevenson, Nathan; Vanhatalo, Sampsa (2017)
    Objective: To develop a method for automated neonatal sleep state classification based on EEG that can be applied over a wide range of age. Methods: We collected 231 EEG recordings from 67 infants between 24 and 45 weeks of postmenstrual age. Ten minute epochs of 8 channel polysomnography (N = 323) from active and quiet sleep were used as a training dataset. We extracted a set of 57 EEG features from the time, frequency, and spatial domains. A greedy algorithm was used to define a reduced feature set to be used in a support vector machine classifier. Results: Performance tests showed that our algorithm was able to classify quiet and active sleep epochs with 85% accuracy, 83% sensitivity, and 87% specificity. The performance was not substantially lowered by reducing the epoch length or EEG channel number. The classifier output was used to construct a novel trend, the sleep state probability index, that improves the visualisation of brain state fluctuations. Conclusions: A robust EEG-based sleep state classifier was developed. It performs consistently well across a large span of postmenstrual ages. Significance: This method enables the visualisation of sleep state in preterm infants which can assist clinical management in the neonatal intensive care unit. (C) 2017 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
  • Boldt, Robert; Mäkelä, Pauliina M.; Immeli, Lotta; Sund, Reijo; Leskinen, Markus; Luukkainen, Päivi; Andersson, Sture (2021)
    Very low birthweight (VLBW) infants are at risk of intraventricular haemorrhage (IVH) and delayed closure of ductus arteriosus. We investigated mean arterially recorded blood pressure (MAP) changes during the first day of life in VLBW infants as potential risk factors for a patent ductus arteriosus (PDA) and IVH. This retrospective cohort study exploring MAP changes during adaption and risk factors for a PDA and IVH comprised 844 VLBW infants admitted to the Helsinki University Children's Hospital during 2005-2013. For each infant, we investigated 600 time-points of MAP recorded 4-24 hours after birth. Based on blood pressure patterns revealed by a data-driven method, we divided the infants into two groups. Group 1 (n = 327, mean birthweight = 1019 g, mean gestational age = 28 + (1/7) weeks) consisted of infants whose mean MAP was lower at 18-24 hours than at 4-10 hours after birth. Group 2 (n = 517, mean birthweight = 1070 g, mean gestational age = 28 + (5/7) weeks) included infants with a higher mean MAP at 18-24 hours than at 4-10 hours after birth. We used the group assignments, MAP, gestational age at birth, relative size for gestational age, surfactant administration, inotrope usage, invasive ventilation, presence of respiratory distress syndrome or sepsis, fluid intake, and administration of antenatal steroids to predict the occurrence of IVH and use of pharmacological or surgical therapy for a PDA before 42 weeks of gestational age. Infants whose mean MAP is lower at 18-24 hours than at 4-10 hours after birth are more likely to undergo surgical ligation of a PDA (odds ratio = 2.1; CI 1.14-3.89; p = 0.018) and to suffer from IVH (odds ratio = 1.83; CI 1.23-2.72; p = 0.003).
  • Virtala, Paula Maarit; Partanen, Eino Juhani (2018)
    Music and musical activities are often a natural part of parenting. As accumulating evidence shows, music can promote auditory and language development in infancy and early childhood. It may even help to support auditory and language skills in infants whose development is compromised by heritable conditions, like the reading deficit dyslexia, or by environmental factors, such as premature birth. For example, infants born to dyslexic parents can have atypical brain responses to speech sounds and subsequent challenges in language development. Children born very preterm, in turn, have an increased likelihood of sensory, cognitive, and motor deficits. To ameliorate these deficits, we have developed early interventions focusing on music. Preliminary results of our ongoing longitudinal studies suggest that music making and parental singing promote infants' early language development and auditory neural processing. Together with previous findings in the field, the present studies highlight the role of active, social music making in supporting auditory and language development in at-risk children and infants. Once completed, the studies will illuminate both risk and protective factors in development and offer a comprehensive model of understanding the promises of music activities in promoting positive developmental outcomes during the first years of life.
  • Forsberg, David; Horn, Zachi; Tserga, Evangelia; Smedler, Erik; Silberberg, Gilad; Shvarev, Yuri; Kaila, Kai; Uhlen, Per; Herlenius, Eric (2016)
    Inflammation-induced release of prostaglandin E-2 (PGE(2)) changes breathing patterns and the response to CO2 levels. This may have fatal consequences in newborn babies and result in sudden infant death. To elucidate the underlying mechanisms, we present a novel breathing brainstem organotypic culture that generates rhythmic neural network and motor activity for 3 weeks. We show that increased CO2 elicits a gap junction-dependent release of PGE(2). This alters neural network activity in the preBotzinger rhythm-generating complex and in the chemosensitive brainstem respiratory regions, thereby increasing sigh frequency and the depth of inspiration. We used mice lacking eicosanoid prostanoid 3 receptors (EP3R), breathing brainstem organotypic slices and optogenetic inhibition of EP3R(+/+) cells to demonstrate that the EP3R is important for the ventilatory response to hypercapnia. Our study identifies a novel pathway linking the inflammatory and respiratory systems, with implications for inspiration and sighs throughout life, and the ability to autoresuscitate when breathing fails.
  • O'Toole, John M.; Boylan, Geraldine B.; Lloyd, Rhodri O.; Goulding, Robert M.; Vanhatalo, Sampsa; Stevenson, Nathan J. (2017)
    Aim: To develop a method that segments preterm EEG into bursts and inter-bursts by extracting and combining multiple EEG features. Methods: Two EEG experts annotated bursts in individual EEG channels for 36 preterm infants with gestational age <30 weeks. The feature set included spectral, amplitude, and frequency-weighted energy features. Using a consensus annotation, feature selection removed redundant features and a support vector machine combined features. Area under the receiver operator characteristic (AUC) and Cohen's kappa (K) evaluated performance within a cross-validation procedure. Results: The proposed channel-independent method improves AUC by 4-5% over existing methods (p <0.001, n = 36), with median (95% confidence interval) AUC of 0.989 (0.973-0.997) and sensitivity -specificity of 95.8-94.4%. Agreement rates between the detector and experts' annotations, K = 0.72 (0.36-0.83) and K = 0.65 (0.32-0.81), are comparable to inter-rater agreement, K = 0.60 (0.21-0.74). Conclusions: Automating the visual identification of bursts in preterm EEG is achievable with a high level of accuracy. Multiple features, combined using a data-driven approach, improves on existing single-feature methods. (C) 2017 The Authors. Published by Elsevier Ltd on behalf of IPEM.
  • Stolt, Suvi; Korja, Riikka; Matomaki, Jaakko; Lapinleimu, Helena; Haataja, Leena; Lehtonen, Liisa (2014)
    Background: It is not clearly understood how the quality of early mother-child interaction influences language development in very-low-birth-weight children (VLBW). Aims: We aim to analyze associations between early language and the quality of mother-child interaction, and, the predictive value of the features of early mother-child interaction on language development at 24 months of corrected age in VLBW children. Study design: A longitudinal prospective follow-up study design was used. Methods: The participants were 28 VLBW children and 34 full-term controls. Language development was measured using different methods at 6, 12 and at 24 months of age. The quality of mother-child interaction was assessed using PC-ERA method at 6 and at 12 months of age. Results: Associations between the features of early interaction and language development were different in the groups of VLBW and full-term children. There were no significant correlations between the features of mother-child interaction and language skills when measured at the same age in the VLBW group. Significant longitudinal correlations were detected in the VLBW group especially if the quality of early interactions was measured at six months and language skills at 2 years of age. However, when the predictive value of the features of early interactions for later poor language performance was analyzed separately, the features of early interaction predicted language skills in the VLBW group only weakly. Conclusions: The biological factors may influence on the language development more in the VLBW children than in the full-term children. The results also underline the role of maternal and dyadic factors in early interactions. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
  • Hukkinen, Maria; Merras-Salmio, Laura; Pakarinen, Mikko P. (2018)
    Treatment results of pediatric intestinal failure have improved markedly during the last decades. With improved survival the attention is turning to other essential outcomes including quality of life and neurodevelopment. So far, relatively few studies with limited number of patients and variable methodology have addressed these issues. Based on these studies using generic health related quality of life tools, children with intestinal failure demonstrate decreased physical health, while PN-dependence is also associated with compromised emotional functioning. Impairments of social functioning are frequently observed among older children and parents. Few recent studies on neurodevelopment imply significant impairments in motor and mental skills among children with intestinal failure despite small sample sizes and limited follow-up times. Development of a disease-specific survey designed for the pediatric intestinal failure population could better reveal the health issues with greatest impact on quality of life. Robust studies with appropriate methodology on neurodevelopment in pediatric intestinal failure with extended follow-up times are urgently needed. Quality of life and neurodevelopment requires greater attention from medical professionals managing children with intestinal failure. (C) 2018 Elsevier Inc. All rights reserved.
  • Pärnänen, Katariina; Karkman, Antti; Hultman, Jenni; Lyra, Christina; Bengtsson-Palme, Johan; Larsson, D. G. Joakim; Rautava, Samuli; Isolauri, Erika; Salminen, Seppo; Kumar, Himanshu; Satokari, Reetta; Virta, Marko (2018)
    The infant gut microbiota has a high abundance of antibiotic resistance genes (ARGs) compared to adults, even in the absence of antibiotic exposure. Here we study potential sources of infant gut ARGs by performing metagenomic sequencing of breast milk, as well as infant and maternal gut microbiomes. We find that fecal ARG and mobile genetic element (MGE) profiles of infants are more similar to those of their own mothers than to those of unrelated mothers. MGEs in mothers' breast milk are also shared with their own infants. Termination of breastfeeding and intrapartum antibiotic prophylaxis of mothers, which have the potential to affect microbial community composition, are associated with higher abundances of specific ARGs, the composition of which is largely shaped by bacterial phylogeny in the infant gut. Our results suggest that infants inherit the legacy of past antibiotic consumption of their mothers via transmission of genes, but microbiota composition still strongly impacts the overall resistance load.
  • Matic, Vladimir; Cherian, Perumpillichira Joseph; Koolen, Ninah; Ansari, Amir H.; Naulaers, Gunnar; Govaert, Paul; Van Huffel, Sabine; De Vos, Maarten; Vanhatalo, Sampsa (2015)
    A quantitative and objective assessment of background electroencephalograph (EEG) in sick neonates remains an everyday clinical challenge. We studied whether long range temporal correlations quantified by detrended fluctuation analysis (DFA) could be used in the neonatal EEG to distinguish different grades of abnormality in the background EEG activity. Long-term EEG records of 34 neonates were collected after perinatal asphyxia, and their background was scored in 1 h epochs (8 h in each neonate) as mild, moderate or severe. We applied DFA on 15 min long, non-overlapping EEG epochs (n = 1088) filtered from 3 to 8 Hz. Our formal feasibility study suggested that DFA exponent can be reliably assessed in only part of the EEG epochs, and in only relatively short time scales (10-60 s), while it becomes ambiguous if longer time scales are considered. This prompted further exploration whether paradigm used for quantifying multifractal DFA (MF-DFA) could be applied in a more efficient way, and whether metrics from MF-DFA paradigm could yield useful benchmark with existing clinical EEG gradings. Comparison of MF-DFA metrics showed a significant difference between three visually assessed background EEG grades. MF-DFA parameters were also significantly correlated to interburst intervals quantified with our previously developed automated detector. Finally, we piloted a monitoring application of MF-DFA metrics and showed their evolution during patient recovery from asphyxia. Our exploratory study showed that neonatal EEG can be quantified using multifractal metrics, which might offer a suitable parameter to quantify the grade of EEG background, or to monitor changes in brain state that take place during long-term brain monitoring.
  • Del Chierico, Federica; Vernocchi, Pamela; Petrucca, Andrea; Paci, Paola; Fuentes, Susana; Pratico, Giulia; Capuani, Giorgio; Masotti, Andrea; Reddel, Sofia; Russo, Alessandra; Vallone, Cristina; Salvatori, Guglielmo; Buffone, Elsa; Signore, Fabrizio; Rigon, Giuliano; Dotta, Andrea; Miccheli, Alfredo; de Vos, Willem M.; Dallapiccola, Bruno; Putignani, Lorenza (2015)
    The colonization and development of gut microbiota immediately after birth is highly variable and depends on several factors, such as delivery mode and modality of feeding during the first months of life. A cohort of 31 mother and neonate pairs, including 25 at-term caesarean (CS) and 6 vaginally (V) delivered neonates (DNs), were included in this study and 121 meconium/faecal samples were collected at days 1 through 30 following birth. Operational taxonomic units (OTUs) were assessed in 69 stool samples by phylogenetic microarray HITChip and inter- and intra-individual distributions were established by inter-OTUs correlation matrices and OTUs co-occurrence or co-exclusion networks. H-1-NMR metabolites were determined in 70 stool samples, PCA analysis was performed on 55 CS DNs samples, and metabolome/OTUs co-correlations were assessed in 45 CS samples, providing an integrated map of the early microbiota OTUs-metabolome. A microbiota "core" of OTUs was identified that was independent of delivery mode and lactation stage, suggesting highly specialized communities that act as seminal colonizers of microbial networks. Correlations among OTUs, metabolites, and OTUs-metabolites revealed metabolic profiles associated with early microbial ecological dynamics, maturation of milk components, and host physiology.
  • Kivi, Anna; Metsäranta, Marjo; Toiviainen-Salo, Sanna; Vanhatalo, Sampsa; Haataja, Leena (2022)
    Aim To characterise the spectrum of findings in sequential neurological examinations, general movements (GM) assessment and magnetic resonance imaging (MRI) of infants with perinatal asphyxia. Methods The prospective cohort study of term infants with perinatal asphyxia treated at Helsinki University Hospital's neonatal units in 2016-2020 used Hammersmith Neonatal Neurological Examination (HNNE) and brain MRI at 2 weeks and Hammersmith Infant Neurological Examination (HINE) and GM assessment at 3 months of age. Results Analysis included 50 infants: 33 displaying perinatal asphyxia without hypoxic-ischaemic encephalopathy (HIE), seven with HIE1 and 10 with HIE2. Of the infants with atypical HNNE findings, 24/25 perinatal asphyxia without HIE cases, 5/6 HIE1 cases and all 10 HIE2 cases showed atypical findings in the HINE. The HINE identified atypical spontaneous movements significantly more often in infants with white matter T2 hyperintensity. Conclusion In this cohort, most infants with perinatal asphyxia, with or without HIE, presented atypical neurological findings in sequential examinations. The profile of neurological findings for children with perinatal asphyxia without HIE resembled that of children with HIE. White matter T2 hyperintensity was associated with atypical spontaneous movements in the HINE and was a frequent MRI finding also in perinatal asphyxia without HIE.
  • Satomaa, Anna-Liisa; Saarenpaa-Heikkila, Outi; Paavonen, E. Juulia; Himanen, Sari-Leena (2016)
    Objective: The lack of standards induces variability in the sleep staging of infants less than two months of age. We evaluated the feasibility of the 2012 AASM sleep scoring rules for healthy one month old infants. Methods: 84 polysomnographies were scored into sleep stages with the adapted AASM criteria. The acquired sleep parameters were compared with the parameters in the literature. In addition the effect of age on sleep was studied. Results: The two independent scorers achieved substantial agreement by using the adapted AASM criteria. The infants' sleep parameters showed marked variability. The amount of active sleep was 36.7% (mean, range 21.3-54.1%), quiet sleep 41.5% (30.3-57.7%) and indeterminate sleep 21.6% (9.7-36.0%). With age sleep became more continuous, but the sleep stage percentages did not change. Our sleep parameters differed clearly from the parameters presented in the literature. Conclusions: The adapted scoring rules were reproducible. This encourages their use in clinical practice, as no uniform recommendations exist. Significance: Normal values are essential in pediatric sleep medicine and the individual variability in the sleep parameters of healthy infants advocates the standardisation of scoring methods. Here we present sleep stage normative values for one month old infants based on the AASM scoring criteria. (C) 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.