► Different longitudinal gestural and linguistic trajectories in preterms and full-terms. ► Slower rate of development and increasing divergence between preterms and full-terms. ► Lexical ...comprehension and gestures/actions support development of lexical production. ► Biological, medical and social risk factors increase preterms’ risk of language delay.
The present study involved a systematic longitudinal analysis, with three points of assessment in the second year of life, of gestures/actions, word comprehension, and word production in a sample of very preterm infants compared to a sample of full-term infants. The relationships among these competencies as well as their predictive value on language development at 24 months and the contribution of biological, medical and social risk factors on language delay at 24 months were also analysed.
One hundred and four monolingual Italian very preterms (mean gestational age 29.5 weeks) without major cerebral damages, and a comparison group of 20 monolingual healthy Italian full-terms were followed at 12, 18 and 24 months by administering to their parents the Italian short forms of the MacArthur-Bates CDI. Preterms showed a slower acquisition in gesture/action production, word comprehension, and word production with an increasing divergence with respect to full-terms from 12 to 24 months, when 20% of preterms were delayed in word production (<10th percentile) and 14% did not combine words yet. Lexical competencies at 12 months and together with gestures/actions at 18 months were predictive of word production at 24 months, with a stronger contribution of word comprehension at 12 months and of word production at 18 months. Male gender, bronchopulmonary dysplasia, and low maternal educational level increased the risk of language delay at 24 months. Our findings suggest there to be a slower rate of communicative-linguistic development in very preterms with an increasing difference in their gestural and lexical competencies in the second year of life with respect to full-terms. The interplay of the above competencies and biological, medical and social risk factors increase the risk of language delay at 24 months in very preterm infants.
The aim of this study was to determine the effect of human milk feeding during NICU hospitalization on neurodevelopment at 24 months of corrected age in very low birth weight infants. A cohort of 316 ...very low birth weight newborns (weight ≤ 1500 g) was prospectively enrolled in a follow-up program on admission to the Neonatal Intensive Care Unit of S. Orsola Hospital, Bologna, Italy, from January 2005 to June 2011. Neurodevelopment was evaluated at 24 months corrected age using the Griffiths Mental Development Scale. The effect of human milk nutrition on neurodevelopment was first investigated using a multiple linear regression model, to adjust for the effects of gestational age, small for gestational age, complications at birth and during hospitalization, growth restriction at discharge and socio-economic status. Path analysis was then used to refine the multiple regression model, taking into account the relationships among predictors and their temporal sequence. Human milk feeding during NICU hospitalization and higher socio-economic status were associated with better neurodevelopment at 24 months in both models. In the path analysis model intraventricular hemorrhage-periventricular leukomalacia and growth restriction at discharge proved to be directly and independently associated with poorer neurodevelopment. Gestational age and growth restriction at birth had indirect significant effects on neurodevelopment, which were mediated by complications that occurred at birth and during hospitalization, growth restriction at discharge and type of feeding. In conclusion, our findings suggest that mother's human milk feeding during hospitalization can be encouraged because it may improve neurodevelopment at 24 months corrected age.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Respiratory Syncytial Virus (RSV) is the most important cause of severe respiratory infections in infants with seasonal epidemics. Environmental factors (temperature, humidity, air pollution) could ...influence RSV epidemics through their effects on virus activity and diffusion.
We conducted a retrospective study on a paediatric population who referred to our Paediatric Emergency Unit in order to analyze the correlation between weekly incidence of RSV positive cases during winter season in Bologna and meteorological factors and air pollutants concentration.
We observed a significant correlation between the incidence of RSV infections and the mean minimum temperature registered during the same week and the previous weeks.The weekly number of RSV positive cases was also correlated to the mean PM10 concentration of the week before.
RSV epidemic trend in Bologna (Italy) is related to the mean minimum temperature, and the mean PM10 concentration.
Abstract Background Since preterm birth is associated with a constellation of pre-, peri- and post-natal risk factors, we hypothesised that prematurity may continue to impact the development of ...linguistic abilities even up to the end of the preschool years and beyond, giving rise to an atypical developmental trajectory. The study tested this hypothesis at six years of age, investigating whether language is affected by preterm birth and how different linguistic abilities are interrelated. Method Seventy monolingual Italian preterms and 34 age-matched controls were recruited. Linguistic abilities (vocabulary, grammar, and phonological awareness) as well as general cognitive developmental levels were measured. Results No general cognitive delay emerged, but less developed abilities in vocabulary, grammar, and phonological awareness were found in preterms compared to fullterms. Moreover, the relations among the different linguistic competences differed across groups. Conclusions Our study shows that even without brain damage, preterm birth continues to affect linguistic development up to the end of the preschool years, and probably beyond, highlighting a continuity between pre- and peri-natal life and subsequent development, and pointing to an atypical developmental trajectory in this population compared to fullterms (different rates of development, different strategies employed, and differences in the relationships among linguistic abilities).
The present study examined maternal responses to infants’ spontaneous communicative behaviors in a sample of 20 extremely-low-gestational-age (ELGA) infants and 20 full-term (FT) infants during 30 ...minutes of play interaction when infants were 12 months of age. Relations between maternal responses and infants’ communication skills at 12 and 24 months were investigated. Maternal responses were coded according to their contingency and degree of relevance to the infant’s communicative signal. Despite the less advanced gestural abilities of ELGA infants, their mothers produced high percentages of contingent and relevant responses, as did mothers of their FT peers. Maternal contingent and highly relevant responses (i.e., those with a repeated label) were associated with ELGA infants’ receptive and expressive communication skills at 12 months and predicted expressive communication skills at 24 months. Results suggest that contingent maternal responses with a repeated label following infants’ spontaneous communicative behaviors support communicative development, particularly among ELGA infants.
The aims of this study were to investigate whether specific linguistic difficulties in preterm children persist at eight years and to examine the interrelationships between language and literacy in ...this population, compared with a control group of full-term children. Sixty-eight monolingual Italian preterms and 26 chronologically matched controls were recruited. Language (grammar comprehension, lexical production and phonological awareness), literacy (reading comprehension, reading and writing) and general cognitive development were investigated. Results showed no general delay in preterms, but slight difficulties in specific linguistic abilities (grammar, lexicon, phoneme synthesis and deletion of the first syllable), more difficulties in literacy (speed in reading and accuracy in writing) and certain correlations among competencies turning out to be different from the control group. In conclusion, our study established that a partially atypical trajectory emerged in preterms, showing specific long-term effects of preterm birth on language and literacy development.
We report a rare case of transient abnormal myelopoiesis (TAM) in a phenotypically normal neonate. The presence of a palpable hepatomegaly prompted in-depth laboratory tests, which revealed the ...presence of severe hyperleukocytosis, with blast cells present in a peripheral blood smear. Although no signs of Down syndrome were present, we suspected TAM. Further analysis identified a mutation in GATA1 along with the unique finding of two different trisomic cell lines, detected upon karyotyping; one with trisomy 21 only, and one with trisomies 21 and 22, which was present in a subpopulation of peripheral blood cells. These genetic abnormalities disappeared by the age of 6 months. The presence of two different trisomic clones may be an evidence of the polyclonal nature of TAM in this patient.
Objective: To verify whether a reduced birth weight for gestational age was associated with a testicular dysfunction in postpubertal boys. Study design: Boys born small for gestational age (SGA) (n = ...25) were compared to 24 born with an appropriate weight. All subjects were postpubertal (mean age 17.5 ± 1.3 and 17.6 ± 2.0 years, respectively). The following clinical and endocrinologic variables were evaluated: final height, target height, body mass index, testicular volume, follicle-stimulating hormone, luteinizing hormone, testosterone, and inhibin B. Results: The SGA group had reduced testicular size (16.3 ± 2.7 mL vs 22.8 ± 3.2 mL; P <.0001) with a lower testosterone level (3.76 ± 1.35 ng/mL vs 4.77 ± 1.55 ng/mL; P <.05) and a higher LH value (4.41 ± 1.61 IU/L vs 3.44 ± 1.29 IU/L; P <.05). Among the SGA group, 54% had a mean testicular volume >2 SD below the control mean (ie, <16 mL) and in these subjects, the inhibin B level was low (143 ± 46 pg/mL vs 229 ± 76 pg/mL; P <.0001). SGA patients with smaller testes had lower final height relative to target height(P <.05 vs patients with larger testes) and for the SGA group, inhibin B correlated with testicular size (P <.0001). Positive correlations also were found between the reduction of final height relative to target height and testicular volume (P <.005) and inhibin B values (P <.05). Conclusions: SGA subjects have pituitary-gonadal axis function that tends toward hypogonadism. There is a disruption of the exocrine function in subjects with smaller testicular size who failed to show a complete height catch-up growth. This study supports a link between low birth weight and lower fertility in adult males. (J Pediatr 2002;141:376-80)
Aim
This cross‐sectional study focused on the effect of very preterm (VPT) birth on language development by analysing phonological, lexical, grammatical, and pragmatic skills and assessing the role ...of cognitive and memory skills.
Method
Sixty children (29 males, 31 females) born VPT (<32wks) aged 5 years were compared with 60 children with typical development. The linguistic assessment was performed by administering a battery of Italian tests for the evaluation of language; cognitive and memory skills were assessed by Raven's coloured progressive matrices and digit span subtest (Wechsler Intelligence Scale for Children WISC‐III).
Results
Children born VPT showed delays in lexical (comprehension: z‐score difference −1.18; 95% confidence interval CI −1.60 to −0.77; naming: −0.88; 95% CI −1.19 to −0.58) and pragmatic skills (comprehension: −0.76; 95% CI −1.02 to −0.49; narrative production: −0.47; 95% CI −0.72 to −0.23). Delays in phonology and grammar were less diffuse, involving productive skills (−1.09; 95% CI −1.64 to −0.54; −0.48; 95% CI −0.85 to −0.12, respectively), and were dependent by cognitive and memory skills. Lexical delays were more specific.
Interpretation
The linguistic profile of children born preterm is characterized by some abilities more impaired than others. This highlights the need of a linguistic assessment at the end of preschool age in order to plan a focused intervention aimed at improving lexical and pragmatic skills.
What this paper adds
Very preterm children showed linguistic delays at 5 years of age.
Impairments are evident in receptive/productive lexical and pragmatic skills.
In phonology and grammar, only productive skills are compromised.
Follow‐up programmes should include a detailed evaluation of language.
This article is commented on by Luinge on pages 895–896 of this issue.
•Less symmetric and more unilateral co-regulation characterises ELGA dyads.•Less positive affective intensity characterises ELGA infants and mothers.•Cognitive, motor and language scores are lower in ...ELGA than in FT infants.•Symmetrical co-regulation is related to motor scores in ELGA infants.•Joint attention, active involvement and positive affect should be fostered in ELGA dyads.
Extremely low gestational age children (ELGA, born below 28 weeks of GA) represent the most at-risk preterm group in terms of survival, developmental sequelae and rates of impairment and cognitive delays. However, the impact of an extremely preterm birth on mother–infant co-regulation and affective intensity which may affect early infant's development has not been investigated. Based on a relational dynamic system approach, our study aimed to investigate the quality of co-regulation and affective intensity during spontaneous play interaction in 20 mother–infant ELGA dyads compared to 20 full-term (FT) dyads at 12 months (corrected age for ELGA infants). Relationships between the quality of dyadic co-regulation and the infant's level of cognitive, motor and language development were also investigated. The quality of dyadic co-regulation was assessed using the Revised Relational Coding System (R-RCS) by Fogel et al. (2003), the mothers’ and infants’ affective intensity was coded using a coding system by Lunkenheimer, Olson, Hollenstein, Sameroff, and Winter (2011). Infants’ development was assessed using the Bayley Scales (BSID-III, 2006). With respect to FT dyads, ELGA dyads were characterised by less frequent symmetric and more frequent unilateral co-regulation patterns and by less positive and more neutral affective intensity of both infants and mothers. Cognitive, motor and language scores were lower in ELGA infants than in FT infants. Symmetrical co-regulation was related to motor scores in ELGA infants, and to cognitive scores in FT infants. Our findings contribute to the literature by demonstrating the difficulties of ELGA mother–infant dyads at 12 months in sharing the symmetric co-regulation and positive affective intensity and how symmetric co-regulation is strictly related to motor development in ELGA infants. Based on these findings, intervention programmes to foster joint attention, active involvement and positive affective intensity in ELGA dyads and infants’ development in the first year of life should be designed.
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