Dataset Information

Longitudinal Changes in the Sensorimotor Pathways of Very Preterm Infants During the First Year of Life With and Without Intervention: A Pilot Study.

ABSTRACT: Objective: Evaluate longitudinal changes in brain microstructure and volumes in very preterm infants during the first year of life with and without intervention.Design: Descriptive pilot study.Methods: Five preterm infants in a three-arm clinical trial, one SPEEDI Early, two SPEEDI Late, and two usual care. Brain structural and diffusion MRI's were acquired within 72 hours after neonatal intensive care unit discharge (n = 5), three months post-baseline (n = 5), and six months post-baseline (n = 3). Fractional anisotropy (FA), Mean diffusivity (MD), and volume metrics were computed for five brain regions.Results: More than 60% of eligible participants completed 100% of the scheduled MRIs. FA and volume increased from baseline to six months across all brain regions. Rate of white matter volume change from baseline to six months was highest in SPEEDI Early.Conclusions: Non-sedated longitudinal MRI is feasible in very preterm infants and appears to demonstrate longitudinal changes in brain structure and connectivity.

SUBMITTER: Khurana S

PROVIDER: S-EPMC8429051 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Longitudinal Changes in the Sensorimotor Pathways of Very Preterm Infants During the First Year of Life With and Without Intervention: A Pilot Study.

Khurana Sonia S Evans Megan E ME Kelly Claire E CE Thompson Deanne K DK Burnsed Jennifer C JC Harper Amy D AD Hendricks-Muñoz Karen D KD Shall Mary S MS Stevenson Richard D RD Inamdar Ketaki K Vorona Gregory G Dusing Stacey C SC

Developmental neurorehabilitation 20210623 7

Objective: Evaluate longitudinal changes in brain microstructure and volumes in very preterm infants during the first year of life with and without intervention.Design: Descriptive pilot study.Methods: Five preterm infants in a three-arm clinical trial, one SPEEDI Early, two SPEEDI Late, and two usual care. Brain structural and diffusion MRI's were acquired within 72 hours after neonatal intensive care unit discharge (n = 5), three months post-baseline (n = 5), and six month ...[more]

PMID: 34160340

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Project description:ObjectivesThe aim of the present study was to examine the changes in bacteria in hospitalized preterm infants during the first month of life.MethodsRectal swabs were collected daily from 12 preterm infants. DNA was extracted from swabs from day of birth and weekly thereafter. Bacterial taxa were identified with next generation sequencing using universal bacterial primers targeted at the 16S ribosomal DNA on a 454 Roche titanium platform. Sequences were clustered into operational taxonomic units, and taxonomy was assigned against the Greengenes databank using Quantitative Insights Into Microbial Ecology version 1.4. Quantitative polymerase chain reaction was used to determine the abundance of Bifidobacterium spp. Functional assessment of the microbiome was performed with Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt).ResultsAverage birth weight and gestational age were 1055 g and 28 weeks, respectively. There were 6 to 35 different bacterial families identified in the day-of-birth samples, unrelated to the mode of delivery. Richness decreased through hospitalization (week 1, 16.9 ± 7.7 vs weeks 3-5, 10.7 ± 3.4, P < 0.001). The Shannon diversity index demonstrated the lowest diversity at birth, an increase at week 2, followed by a rapid decline at weeks 3 to 5, suggesting the development of a more uniform microbiota composition after 2 weeks of stay at a neonatal intensive care unit. Enterobacteriaceae, Staphylococcaceae, and Enterococcaceae constituted the majority of the bacterial families. Bifidobacterium spp were infrequently detected at extremely low levels. PICRUSt analysis revealed the enhancement of peroxisome, PPAR, and adipocytokine signaling; plant-pathogen interaction; and aminobenzoate degradation pathways in week 1 samples.ConclusionsOur results suggest that although preterm infants have individualized microbiota that are detectable at birth, the differences decrease during the neonatal intensive care unit hospitalization with increasing prominence of pathogenic microbiota.

Project description:ImportanceEarly intervention can improve cognitive outcomes for very preterm infants but is resource intensive. Identifying those who need early intervention most is important.ObjectiveTo evaluate a model for use in very preterm infants to predict cognitive delay at 2 years of age using routinely available clinical and sociodemographic data.Design, setting, and participantsThis prognostic study was based on the Swedish Neonatal Quality Register. Nationwide coverage of neonatal data was reached in 2011, and registration of follow-up data opened on January 1, 2015, with inclusion ending on September 31, 2022. A variety of machine learning models were trained and tested to predict cognitive delay. Surviving infants from neonatal units in Sweden with a gestational age younger than 32 weeks and complete data for the Bayley Scales of Infant and Toddler Development, Third Edition cognitive index or cognitive scale scores at 2 years of corrected age were assessed. Infants with major congenital anomalies were excluded.ExposuresA total of 90 variables (containing sociodemographic and clinical information on conditions, investigations, and treatments initiated during pregnancy, delivery, and neonatal unit admission) were examined for predictability.Main outcomes and measuresThe main outcome was cognitive function at 2 years, categorized as screening positive for cognitive delay (cognitive index score <90) or exhibiting typical cognitive development (score ≥90).ResultsA total of 1062 children (median [IQR] birth weight, 880 [720-1100] g; 566 [53.3%] male) were included in the modeling process, of whom 231 (21.8%) had cognitive delay. A logistic regression model containing 26 predictive features achieved an area under the receiver operating curve of 0.77 (95% CI, 0.71-0.83). The 5 most important features for cognitive delay were non-Scandinavian family language, prolonged duration of hospitalization, low birth weight, discharge to other destination than home, and the infant not receiving breastmilk on discharge. At discharge from the neonatal unit, the full model could correctly identify 605 of 650 infants who would have cognitive delay at 24 months (sensitivity, 0.93) and 1081 of 2350 who would not (specificity, 0.46).Conclusions and relevanceThe findings of this study suggest that predictive modeling in neonatal care could enable early and targeted intervention for very preterm infants most at risk for developing cognitive impairment.

Dataset Information

Longitudinal Changes in the Sensorimotor Pathways of Very Preterm Infants During the First Year of Life With and Without Intervention: A Pilot Study.

Publications

Longitudinal Changes in the Sensorimotor Pathways of Very Preterm Infants During the First Year of Life With and Without Intervention: A Pilot Study.

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