Similar neuro outcomes in preterm infants with low-grade brain bleeding as infants with no bleeding

Findings differ from previous study; UH Rainbow Babies and Children's Hospital researcher lead author

2013-03-18

(Press-News.org) A new study from researchers at UH Rainbow Babies and Children's Hospital and other centers suggests that preterm infants with a low-grade bleeding in the brain may have similar neurodevelopmental outcomes as infants with no bleeding. The study appears online at JAMA Pediatrics.

The study's lead author Allison Payne, MD MS, a neonatologist at UH Rainbow Babies and Children's Hospital and instructor at Case Western Reserve University School of Medicine, said, "The results are important because it is a large multi-center study showing different results than a recent study that did find differences in outcomes at 2 years of age for babies with PIVH. Our study's results are similar to those reported by other international cohorts."

The bleeding is called periventricular-intraventricular hemorrhage (PIVH), a condition that can occur in preterm babies. Dr. Payne and her colleagues said that although the presence of severe PIVH strongly correlates with adverse motor and cognitive outcomes, "outcomes of survivors with low-grade PIVH (grade 1 or 2) are less fully understood despite accounting for 50 percent to 80 percent of all PIVH cases."

In this study, the researchers analyzed 1472 extremely preterm infants admitted to 16 pediatric medical centers, including UH Rainbow Babies and Children's Hospital, from 2006 to 2008 who survived to 18-22 months and had at least one cranial ultrasonography performed during their stay.

In total, 451 infants were diagnosed with PIVH, of which 31 percent were classified as having grade 1 PIVH, 29 percent as having grade 2, and 40 percent as having grade 3 or 4. Infants with grade 1 or 2 PIVH did not have an increased incidence of poor neurodevelopmental outcomes at 18-22 months compared with infants without PIVH, even after multivariate analysis controlling for potential confounders, including the use of antenatal and postnatal steroids.

Compared with low-grade hemorrhage, severe (grade 3 or 4) hemorrhage was significantly associated with cognitive deficits and language delay, as well as an increased risk for poor nonsensory outcomes (including cerebral palsy) apart from mild language impairment and severe cognitive impairment.

The researchers caution that high-prevalence, low-severity disabilities, such as attention deficit/hyperactivity disorders, specific neuropsychological deficits, and behavioral problems may gradually emerge over the years. "It is not clear what contribution low-grade PIVH may have to these more subtle disabilities," said Dr. Payne. She plans to continue to study these children when they reach school age.

### Other authors on the paper from UH Rainbow Babies and Children's Hospital are Anna Maria Hibbs, MD, MS; Michele C. Walsh, MD, MS, and Deanne E. Wilson-Costello, MD. The research was supported by the National Institutes of Health (NIH) and Rainbow Babies and Children's Foundation Fellowship Research Award Program. NIH; Eunice Kennedy Shriver National Institute of Child Health and Human Development; National Center for Research Resources, and National Center for Advancing Translational Sciences provided grant support for the Neonatal Research Network's Generic Database and Follow-up Studies.

ELSE PRESS RELEASES FROM THIS DATE:

New Evaluation of the Heart Truth® Professional Education Materials Released

2013-03-18

WASHINGTON, DC – Heart disease is the leading cause of death for women in the United States. Yet historically, women have been less likely than men to receive evidence-based medical care for both the prevention and management of heart disease. In 1999 the American Heart Association (AHA) published the first clinical recommendations for the prevention of cardiovascular disease (CVD) in women. This was soon followed by the implementation of The Heart Truth® campaign for consumers in 2002 by the National Heart, Lung, and Blood Institute (NHLBI), which was expanded in 2004 ...

Cell on a chip reveals protein behavior

2013-03-18

For years, scientists around the world have dreamed of building a complete, functional, artificial cell. Though this vision is still a distant blur on the horizon, many are making progress on various fronts. Prof. Roy Bar-Ziv and his research team in the Weizmann Institute's Material's and Interfaces Department recently took a significant step in this direction when they created a two-dimensional, cell-like system on a glass chip. This system, composed of some of the basic biological molecules found in cells – DNA, RNA, proteins – carried out one of the central functions ...

University of California's unofficial favorite sea slug poised to make a comeback

2013-03-18

(Santa Barbara, Calif.) –– After almost four decades of absence from local waters, a special sea slug appears to be making a comeback, and marine scientists at UC Santa Barbara are eagerly anticipating its return. With its vivid blue and gold colors and its discovery by UC zoologists in 1901, the nudibranch Felimare californiensis, also known as the California chromodorid, has been a favorite species of sea slug for UC marine scientists and students for decades. But while it held a special place in their hearts, it lost its place in local waters, which once included La ...

Causing collapse

2013-03-18

One of the most basic laws of quantum mechanics is that a system can be in more than one state – it can exist in multiple realities – at once. This phenomenon, known as the superposition principle, exists only so long as the system is not observed or measured in any way. As soon as such a system is measured, its superposition collapses into a single state. Thus, we, who are constantly observing and measuring, experience the world around us as existing in a single reality. The principle of superposition was first demonstrated in 1922 by Otto Stern and Walther Gerlach, ...

Digital rectal exam remains important part of prostate screening

2013-03-18

The digital rectal exam is an important screening test that can discover prostate cancer that a prostate-specific antigen or PSA test may not, despite the higher sensitivity of the PSA test, according to Penn State College of Medicine researchers. The digital rectal examination is a procedure where a physician feels the surface of the prostate with a gloved finger. The doctor is able to feel any lumps or hard areas on the prostate. A PSA test checks for levels of prostate-specific antigen in the blood, with higher levels signaling potential cancer. As men age, the ...

Food memories can help with weight loss

2013-03-18

Research led by a psychologist at the University of Liverpool has found that using memories of recent meals reduces the amount of food eaten later on. It also found that being distracted when eating leads to increased consumption. Researchers analysed 24 separate studies which had examined the impact of awareness, attention, memory and distraction on how much food we eat. They found that remembering meals, being more aware and paying added attention to meals results in lower food consumption and could help with weight loss programmes. Techniques such as writing down ...

Programmed destruction

2013-03-18

Stroke, heart attacks and numerous other common disorders result in a massive destruction of cells and tissues called necrosis. It's a violent event: As each cell dies, its membrane ruptures, releasing substances that trigger inflammation, which in turn can cause more cellular necrosis. A new Weizmann Institute study may help develop targeted therapies for controlling the tissue destruction resulting from inflammation and necrosis. The study, conducted in the laboratory of Prof. David Wallach of the Biological Chemistry Department, focused on a group of signaling enzymes, ...

Researchers propose a novel prognostic model for disease-specific survival in BCa patients

2013-03-18

Milan, 18 March 2013 – A new study from Japan investigated various prognostic indicators, including clinico-pathological and pre-operative hematological factors to develop a novel prognostic factors-based risk stratification model for disease-specific survival (DSS) in bladder cancer (BCa) patients treated with radical cystectomy (RC). This large series demonstrated that two types of pre-operative haematological disorders assessed by haemoglobin (Hb) and C-reacted protein (CRP) are independent prognostic indicators for patients with BCa treated by RC. "Despite the wealth ...

Third-party blood stem cell transplantation as a factor to impact on poor graft function

2013-03-18

The study appears as an early e-publication for the journal Cell Transplantation, and is now freely available on-line at http://www.ingentaconnect.com/content/cog/ct/pre-prints/ct0832liu. "Allogenic hematopoietic stem cell transplantation can cure many hematologic diseases," said study co-author Dr. Qifa Liu of the Southern Medical University in Guangzhou, China. "However, poor graft function is a complication that occurs in five to 27 percent of patients receiving allo-HSCT and is associated with considerable morbidity and mortality." According to the researchers, ...

Study: Widespread 'test-and-treat' HIV policies could increase dangerous drug resistance

2013-03-18

One of the most widely advocated strategies for dealing with HIV/AIDS could double the number of multi-drug-resistant HIV cases in the population of men who have sex with men (MSM) in LA County over the next 10 years, cautions a new study. In the United States, LA County has the largest incident population of HIV positive individuals. The so-called "test and treat" policy — which calls for universal testing for HIV as well as treatment with antiretroviral drugs for even those at the earliest stages of the disease — is popular because it has been shown to decrease the ...

LAST 30 PRESS RELEASES:

Awareness of lung cancer screening remains low

Hospital COVID-19 burden and adverse event rates

NSF NOIRLab astronomers discover the fastest-feeding black hole in the early universe

Translational science reviews—a new JAMA review

How the keto diet could one day treat autoimmune disorders

Influence of tool corner radius on chip geometrical characteristics of machining Zr-based bulk metallic glass

Megan Huisingh-Scheetz, MD, MPH, of the University of Chicago recognized with AFAR’s Terrie Fox Wetle Rising Star Award in Health Services and Aging Research