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  • 1
    Online Resource
    Online Resource
    Academic Achievement Deficits and Their Neuropsychological Correlates in Children Born Extremely Preterm
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Journal of Developmental & Behavioral Pediatrics Vol. 38, No. 8 ( 2017-10), p. 627-637
    Details
    In: Journal of Developmental & Behavioral Pediatrics, Ovid Technologies (Wolters Kluwer Health), Vol. 38, No. 8 ( 2017-10), p. 627-637
    Abstract: The purpose of this study was to examine the risks associated with learning disabilities (LDs) in a large sample of children born extremely preterm. We predicted higher than expected rates of LD, particularly in math, and children with LD in math, reading, or both would have lower intelligence quotients (IQs) and specific patterns of neuropsychological deficits. Methods: We evaluated academic achievement, rates of LD, and their neuropsychological correlates in the Extremely Low Gestational Age Newborns (ELGANs) Study cohort of 10-year-old children born at 23 to 27 weeks gestational age. Primary analyses focused on children without intellectual disability (verbal IQ 〉 70 and nonverbal IQ 〉 70; N = 668). Low achievement was defined as a standard score ≤85 on the reading or math measures. Results: The risk of low math achievement scores (27%) was 1.5 times higher than the risk of low reading achievement scores (17%). Children were classified as having LD based on low achievement criteria in reading only (RD, 6.4% of sample), math only (MD, 16.2%), both reading and math (RD/MD, 8.3%), or no reading or math disabilities (No LD, 69.1%). Although all 3 LD groups had multiple neuropsychological weaknesses compared with the No LD group, the RD and MD groups had different patterns of neuropsychological impairment. Conclusion: These children from the ELGAN cohort had higher than expected rates of LD, particularly in mathematics, even after taking socioeconomic status into consideration. These results indicate specific cognitive weaknesses that differ between extremely preterm children with RD and MD.
    Type of Medium: Online Resource
    ISSN: 0196-206X
    URL: Article
    DOI: 10.1097/DBP.0000000000000479
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2062814-6
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  • 2
    Online Resource
    Online Resource
    Psychiatric Symptoms: Prevalence, Co-occurrence, and Functioning Among Extremely Low Gestational Age Newborns at Age 10 Years
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Journal of Developmental & Behavioral Pediatrics Vol. 40, No. 9 ( 2019-12), p. 725-734
    Details
    In: Journal of Developmental & Behavioral Pediatrics, Ovid Technologies (Wolters Kluwer Health), Vol. 40, No. 9 ( 2019-12), p. 725-734
    Abstract: To evaluate the percentage of children born extremely preterm (EP) who screen positive for ≥1 DSM-IV psychiatric disorders, the co-occurrence of and sex-related differences in these classifications, and the functional correlates of psychiatric symptoms. Methods: The Extremely Low Gestational Age Newborn (ELGAN) Study is a prospective cohort follow-up of children born 〈 28 weeks' gestation. For 871 10-year-old children, parents completed the Child Symptom Inventory-4 (CSI-4), a child educational/medical history questionnaire, and the Pediatric Quality of Life Inventory (PedsQL). Results: At age 10 years, ELGANs were more likely to screen positive for a number of psychiatric disorders when compared with normative expectations on the CSI-4, with a few sex-related differences. Fifteen percent of participants screened positive for 1 disorder, 7% for 2, 3% for 3, and 4% for ≥4 psychiatric disorders. Compared with children who did not screen positive for psychiatric disorders, children who screened positive for ≥3 psychiatric disorders were approximately twice as likely to have repeated a grade, have an individualized educational program, have an individual school aide, and to require special remediation classes. Children who screened positive for any psychiatric disorder were 4 times more likely to use 1 or more psychotropic medication, and those who screened positive for ≥2 psychiatric disorders had lower PedsQL scores. Conclusion: Among 10-year-old children born EP, rates of psychiatric symptoms exceeded normative expectation, and children who screened positive for more than 1 psychiatric disorder were at increased risk of having multiple functional impairments.
    Type of Medium: Online Resource
    ISSN: 0196-206X
    URL: Article
    DOI: 10.1097/DBP.0000000000000744
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 3
    Online Resource
    Online Resource
    Social Responsiveness Scale Assessment of the Preterm Behavioral Phenotype in 10-Year-Olds Born Extremely Preterm
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Journal of Developmental & Behavioral Pediatrics Vol. 38, No. 9 ( 2017-11), p. 697-705
    Details
    In: Journal of Developmental & Behavioral Pediatrics, Ovid Technologies (Wolters Kluwer Health), Vol. 38, No. 9 ( 2017-11), p. 697-705
    Abstract: To evaluate the correlates of a clinically significant high score on the Social Responsiveness Scale (SRS) in 10-year-old children who were born extremely preterm and who did not meet criteria for autism spectrum disorder (ASD). Methods: After excluding 61 participants diagnosed with ASD, we grouped children by IQ 〈 or ≥85 and then compared the prevalence of neurocognitive and other deficits between those who had SRS total and component scores ≥65 and their peers who had lower scores. Results: Among children who had IQ ≥ 85, the prevalence of SRS total scores ≥65 was 16% (n = 103/628), and among children who had IQ 〈 85, it was 27% (n = 40/148), higher than the 4% prevalence expected based on normative population data. Among children who had IQ ≥ 85, those who had high SRS scores more often than their peers had deficits in attention and executive function, and language and communication, and they were more often rated by their parents and teachers as having behavioral (e.g., attention-deficit hyperactivity disorder [ADHD]) and emotional (e.g., anxiety and depression) problems. Conclusion: Social Responsiveness Scale–defined social impairment was much more common in our cohort of 10-year-old children born extremely preterm than was expected based on general population norms. High SRS scores were characteristic of children who had intellectual, neurocognitive, language, and communication limitations, as well as deficits in behavior and emotion regulation.
    Type of Medium: Online Resource
    ISSN: 0196-206X
    URL: Article
    DOI: 10.1097/DBP.0000000000000485
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
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  • 4
    Online Resource
    Online Resource
    Intraoperative Hyperglycemia during Infant Cardiac Surgery Is Not Associated with Adverse Neurodevelopmental Outcomes at 1, 4, and 8 Years
    Ovid Technologies (Wolters Kluwer Health) ; 2004
    In:  Anesthesiology Vol. 100, No. 6 ( 2004-06-01), p. 1345-1352
    Details
    In: Anesthesiology, Ovid Technologies (Wolters Kluwer Health), Vol. 100, No. 6 ( 2004-06-01), p. 1345-1352
    Abstract: It is unknown whether intraoperative hyperglycemia in infants is associated with worse neurodevelopmental outcomes after low-flow cardiopulmonary bypass (LF), deep hypothermic circulatory arrest (CA), or both. Methods In a database review of a prospective trial of 171 infants undergoing arterial switch for D-transposition of the great arteries who were randomly assigned to predominantly LF or CA, glucose was measured after induction (T1), 5 min after cardiopulmonary bypass onset (T2), at the onset of CA or LF (T3), 5 min after CPB resumption (T4), at rewarming to 32 degrees C (T5), 10 min after cardiopulmonary bypass weaning (T6), and 90 min after CA or LF (T7). Outcomes included seizures, electroencephalographic findings, and neurodevelopmental evaluation at 1, 4, and 8 yr. Results Glucose concentrations were affected by support strategy and age at surgery. Lower glucose in the entire group at T6-T7 tended to predict electroencephalographic seizures (P = 0.06 and P = 0.007) but was not related to clinical seizures. Within the predominantly CA group, higher glucose did not correlate with worse outcomes. Rather, it was associated with more rapid electroencephalographic normalization of "close burst" and "relative continuous" activity at all times except T2 (P & lt; or = 0.03), a finding more pronounced in infants aged 7 days old or younger. Intraoperative serum glucose concentrations were unrelated to neurodevelopmental outcomes at ages 1, 4, and 8 yr. Conclusions Low glucose after cardiopulmonary bypass tended to relate to electroencephalographic seizures and slower electroencephalogram recovery, independent of CA duration. High glucose concentrations were not associated with worse neurodevelopmental outcomes. Avoiding hypoglycemia may be preferable to restricting glucose in infants undergoing heart surgery.
    Type of Medium: Online Resource
    ISSN: 0003-3022
    URL: Article
    DOI: 10.1097/00000542-200406000-00005
    RVK:
    XA 22600
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2004
    detail.hit.zdb_id: 2016092-6
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  • 5
    Online Resource
    Online Resource
    Relation of Seizures After Cardiac Surgery in Early Infancy to Neurodevelopmental Outcome
    Ovid Technologies (Wolters Kluwer Health) ; 1998
    In:  Circulation Vol. 97, No. 8 ( 1998-03-03), p. 773-779
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 97, No. 8 ( 1998-03-03), p. 773-779
    Abstract: Background —The outcome of infants who have transient seizures after open heart surgery has not been studied. Using the database of the Boston Circulatory Arrest Study involving 171 children with D-transposition of the great arteries, we explored the relationship between early postoperative clinical and EEG seizures and neurodevelopmental outcomes at ages 1 and 21/2 years. Methods and Results —At 1 year, children returned for developmental and neurological evaluations and MRI. Parent-completed developmental questionnaires were collected at 2 1/2 years of age. At 1 year, children with early postoperative seizures had lower Psychomotor Development Index (motor function) scores (clinical seizures: 12.9 mean difference [MD]; 95% confidence interval [CI] , 2.2 to 23.6; P =.02; EEG seizures: 13.3 MD; 95% CI, 6.8 to 19.7; P 〈 .001). Mental Developmental Index scores of children with clinical or EEG seizures were also lower, but the differences were not statistically significant. Infants with seizures were more likely to have an abnormal neurological examination (clinical seizures: 78% versus 31%; P =.008; EEG seizures: 58% versus 34%; P =.04). Children with EEG seizures were more likely to have MRI abnormalities (43% versus 13%, P =.002). At age 21/2, children with EEG seizures had lower scores in several areas of function. Conclusions —In infants undergoing the arterial switch operation for correction of D-transposition of the great arteries, transient postoperative clinical and EEG seizures were associated with worse neurodevelopmental outcomes at ages 1 and 2 1/2 years as well as neurological and MRI abnormalities at 1 year of age. The occurrence of such seizures may provide an early sign of brain injury with neurological and developmental sequelae.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/01.CIR.97.8.773
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1998
    detail.hit.zdb_id: 1466401-X
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  • 6
    Online Resource
    Online Resource
    Antenatal Corticosteroids Appear to Reduce the Risk of Postnatal Germinal Matrix Hemorrhage in Intubated Low Birth Weight Newborns
    Ovid Technologies (Wolters Kluwer Health) ; 1994
    In:  Obstetrical & Gynecological Survey Vol. 49, No. 1 ( 1994-01), p. 20-
    Details
    In: Obstetrical & Gynecological Survey, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. 1 ( 1994-01), p. 20-
    Type of Medium: Online Resource
    ISSN: 0029-7828
    URL: Article
    DOI: 10.1097/00006254-199401000-00010
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1994
    detail.hit.zdb_id: 2043471-6
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  • 7
    Online Resource
    Online Resource
    Neurocognitive and Academic Outcomes at Age 10 Years of Extremely Preterm Newborns
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Obstetrical & Gynecological Survey Vol. 71, No. 8 ( 2016-08), p. 457-458
    Details
    In: Obstetrical & Gynecological Survey, Ovid Technologies (Wolters Kluwer Health), Vol. 71, No. 8 ( 2016-08), p. 457-458
    Type of Medium: Online Resource
    ISSN: 0029-7828
    URL: Article
    DOI: 10.1097/OGX.0000000000000354
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2043471-6
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  • 8
    Online Resource
    Online Resource
    Developmental and Neurological Status of Children at 4 Years of Age After Heart Surgery With Hypothermic Circulatory Arrest or Low-Flow Cardiopulmonary Bypass
    Ovid Technologies (Wolters Kluwer Health) ; 1999
    In:  Circulation Vol. 100, No. 5 ( 1999-08-03), p. 526-532
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 100, No. 5 ( 1999-08-03), p. 526-532
    Abstract: Background —It is not known whether developmental and neurological outcomes in the preschool period differ depending on whether the predominant vital organ support strategy used in infant heart surgery was total circulatory arrest (CA) or low-flow cardiopulmonary bypass. Methods and Results —Infants with D-transposition of the great arteries who underwent an arterial-switch operation were randomly assigned to a support method consisting predominantly of CA or low-flow cardiopulmonary bypass. Developmental and neurological status were evaluated blindly at 4 years of age in 158 of 163 eligible children (97%). Neither IQ scores nor overall neurological status were significantly associated with either treatment group or duration of CA. The CA group scored lower on tests of motor function (gross motor, P =0.01; fine motor, P =0.03) and had more severe speech abnormalities (oromotor apraxia, P =0.007). Seizures in the perioperative period, detected either clinically or by continuous electroencephalographic monitoring, were associated with lower mean IQ scores (12.6 and 7.7 points, respectively) and increased risk of neurological abnormalities (odds ratios, 8.4 and 5.6, respectively). The performance of the full cohort was below expectations in several domains, including IQ, expressive language, visual-motor integration, motor function, and oromotor control. Conclusions —Use of CA to support vital organs during open heart surgery in infancy is associated, at the age of 4 years, with worse motor coordination and planning but not with lower IQ or with worse overall neurological status.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/01.CIR.100.5.526
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1999
    detail.hit.zdb_id: 1466401-X
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  • 9
    Online Resource
    Online Resource
    Neurocognitive Correlates of Attention-Deficit Hyperactivity Disorder Symptoms in Children Born at Extremely Low Gestational Age
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Journal of Developmental & Behavioral Pediatrics Vol. 38, No. 4 ( 2017-05), p. 249-259
    Details
    In: Journal of Developmental & Behavioral Pediatrics, Ovid Technologies (Wolters Kluwer Health), Vol. 38, No. 4 ( 2017-05), p. 249-259
    Abstract: Compared with children born near term, those born extremely preterm (EP) are at much higher risk for attention-deficit hyperactivity disorder (ADHD). Little information is available about differences in neuropsychological outcomes among EP children with and without ADHD. Our analyses aimed to evaluate the neuropsychological correlates of ADHD symptoms in extremely low gestational age newborns (ELGANs). Methods: We obtained Child Symptom Inventory-4 reports from parents (n = 871) and teachers (n = 634) of 10-year-old children born before the 28th week of gestation. Participants completed standardized assessments of neurocognitive and academic functioning. Results: In the total sample, children who screened positive for ADHD symptoms were at increased risk for neurocognitive limitations. These associations were weaker when the sample was limited to those with intelligence quotient (IQ) ≥70 or ≥85. Even those with IQ ≥85 who screened positive for ADHD symptoms were more likely than their peers to have deficits on the DAS-II Working Memory Cluster and the NEPSY-II Auditory Response subtest. The risks for impaired academic performance (Z ≤ −1) on components of the WIAT-III were 2-to-3 times higher in this group than among ELGANs not classified as having ADHD symptoms. Conclusion: Among children born EP, those with ADHD symptoms are more likely to have global neurocognitive impairment. When IQ is within normal limits, ADHD symptoms are associated with deficits in executive functioning skills. These findings highlight a group at risk for executive functioning deficits and related academic difficulties, even in the absence of intellectual disability.
    Type of Medium: Online Resource
    ISSN: 0196-206X
    URL: Article
    DOI: 10.1097/DBP.0000000000000436
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2062814-6
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