Low-grade IVH in preterm infants causes cerebellar damage, motor, and cognitive impairment.

BACKGROUND: Few studies have examined the effect of low-grade intraventricular hemorrhage (IVH) on the white matter in the cerebellum and its association with neurodevelopment. We evaluated cerebellar white matter at term-equivalent age (TEA) in preterm infants with low-grade IVH. Furthermore, we assessed neurodevelopmental outcomes at 3 years of age to examine the influence of low-grade IVH on neurodevelopment. METHODS: Thirteen infants with low-grade IVH and 26 without IVH, born at <30 weeks' postmenstrual age (PMA), were enrolled in this study. Diffusion tensor imaging (DTI) parameters, including fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in the middle and superior cerebellar peduncles (SCP), were measured. Neurodevelopmental outcomes at three years of age were assessed and the correlation between DTI parameters and developmental quotient (DQ) was analyzed. RESULTS: Preterm infants with IVH showed lower FA values (P < 0.01) and higher ADC values (P < 0.05) in the SCP at TEA than the no-IVH group. Lower Postural-Motor and Cognitive-Adaptive DQ at 3 years of age were observed in the IVH compared to the no-IVH group. A significant correlation between the FA values in the SCP at TEA and the Posture-Motor DQ was observed at three years of age (P = 0.043, r = 0.50). CONCLUSIONS: These data suggest that low-grade IVH in preterm infants affects the SCP at TEA and that impaired cerebellar white matter correlates with poor motor development at three years of age.

[A follow-up study of 6-year-old kindergarten children at one year after they participated in a pilot medical examination].

A follow-up study of 129 kindergarten children was undertaken in 2007 by the same questionnaire survey among nurses that was conducted as a part of pilot study in 2006. Among 103 children, 86 were comprehensively assessed as "normal", and 17 had been assessed to have difficulties in group action at the pilot medical examination. In the follow-up study, we found that among the children who were previously been assessed as "normal", approximately 90 percent were re-assessed as "normal", though 10 percent of them showed signs of mild delay and/or failure to adapt in group action; and that 65 percent of the 17 children who were assessed to have difficulties in group action at the pilot medical examination showed signs of failure to adapt in group action and/or mild delay. Utilizing K statistics, the analysis of coincidences between the answer to the questionnaires for nurses obtained at the pilot medical examination and those obtained in follow-up study revealed that little improvement could be expected by altering daily care for children with such behavioral problems characterized as "poor concentration due to the stimulation from outside", "clumsiness" and "restlessness". It was suggested that these behavioral problems were due to biological traits;whereas in problems as "a tendency to persistence", "does not follow instructions", "does not remain seated" and "apt to be in a temper", improvements could be expected when adjustments were made in the environment of daily life.

Gender differences in occurrence of behavioral and emotional problems at the lower grades of elementary school: Association with developmental and behavioral characteristics at 5 years.

AIM: We examined whether developmental status and behavioral problems at age five were related to the occurrence of behavioral and emotional problems in the lower grades of elementary school among non-clinical children who did not receive specialized support for developmental problems in early childhood. METHODS: The participants were 367 (non-clinical: 325) second- and third-grade elementary school children. The mean age at follow-up was 7.63 (SD = 0.62). Parents completed a questionnaire about their children's developmental status and behavioral problems during a community health check-up for 5-year-olds. Behavioral and emotional problems at school age were assessed using the Strengths and Difficulties Questionnaire (SDQ). The association between developmental and behavioral characteristics at age five and each of the SDQ subscales at school age was analyzed with logistic regression. RESULTS: Hyperactivity/inattention, conduct problems, and emotional problems at school age were associated with developmental and behavioral factors in 5-year-olds. The problem of hyperactivity/inattention at school age was associated with hyperactivity/inattention in both genders, and significant gender differences were identified. The relationship with hyperactivity at the age of five was significant for boys, whereas the relationship with inattention was only significant for girls. Emotional problems were significantly associated with social behaviors and developmental status at five years of age only in girls. CONCLUSIONS: It is necessary for clinicians and teachers to consider the relation of developmental and behavioral characteristics to the background of behavioral and emotional problems at school age and to be aware of gender differences.