Screening preterm-born infants for autistic traits may help to identify social communication difficulties at five years of age.

AIM: This study compared neurodevelopmental screening questionnaires completed when preterm-born children reached 2 years of corrected age with social communication skills at 5.5 years of age. METHODS: Eligible subjects were born in 2011 at 24-34 weeks of gestation, participated in a French population-based epidemiological study and were free of motor and sensory impairment at 2 years of corrected age. The Ages and Stages Questionnaire (ASQ) and the Modified Checklist for Autism in Toddlers (M-CHAT) were used at 2 years and the Social Communication Questionnaire (SCQ) at 5.5 years of age. RESULTS: We focused on 2119 children. At 2 years of corrected age, the M-CHAT showed autistic traits in 20.7%, 18.5% and 18.2% of the children born at 24-26, 27-31 and 32-34 weeks of gestation, respectively (p = 0.7). At 5.5 years of age, 12.6%, 12.7% and 9.6% risked social communication difficulties, with an SCQ score ≥90th percentile (p = 0.2). A positive M-CHAT score at 2 years was associated with higher risks of social communication difficulties at 5.5 years of age (odds ratio 3.46, 95% confidence interval 2.04-5.86, p < 0.001). Stratifying ASQ scores produced similar results. CONCLUSION: Using parental neurodevelopmental screening questionnaires for preterm-born children helped to identify the risk of later social communication difficulties.

Neurodevelopment at 24 months corrected age in extremely preterm infants treated with dexamethasone alternatives during the late postnatal period: a cohort study.

The administration of dexamethasone has been associated with suboptimal neurodevelopment. We aimed to compare the development of extremely premature infants treated or not with alternatives to dexamethasone: betamethasone, hydrocortisone hemisuccinate. This retrospective cohort study included infants born before 29 weeks of gestational age, treated or not with late (day ≥ 7) postnatal steroids (betamethasone, hydrocortisone hemisuccinate). The neurodevelopment outcome was evaluated at 24 months corrected age, after adjustment on comorbidities of extreme prematurity. In order to analyse their overall development, data about growth and respiratory outcomes were collected. Among the 192 infants included, 59 (30.7%) received postnatal steroids. Suboptimal neurodevelopment concerned 37/59 (62.7%) postnatal steroid-treated and 43/133 (38.1%; p = 0.002) untreated infants. However, in multivariable analysis, only severe neonatal morbidity (p = 0.007) and male gender (p = 0.027) were associated with suboptimal neurodevelopment outcome at 24 months.  Conclusions: Betamethasone or hydrocortisone hemisuccinate treatment was not an independent risk for suboptimal neurological development, growth and respiratory outcomes assessed at 24 months corrected age in extremely premature infants.  Registration number: The study was registered on the ClinicalTrials.gov register: NCT05055193. What is Known: • Late postnatal steroids are used to treat bronchopulmonary dysplasia • Meta-analyses warned against the neurological risk of dexamethasone use during neonatal period. Early or late hydrocortisone hemisuccinate has been evaluated in multiple studies, none of which have reported an adverse effect on neurodevelopment at least to 2 years. Data about the use of betamethasone are scarce. What is New: • The risk of suboptimal neurodevelopment was higher among extremely premature infants who received postnatal steroids when compared to those who did not. • Betamethasone and hydrocortisone hemisuccinate treatment was not an independent risk factor for suboptimal neurodevelopment at 24 months corrected age.

Air and Water Processes Do Not Produce the Same High-Quality Pasteurization of Donor Human Milk.

BACKGROUND: Holder pasteurization is the most commonly used technique in milk banks worldwide, but higher temperatures and longer pasteurization time have been associated with damage to the immune components of human milk. Research aim: This study aimed to assess the detailed pattern of pasteurization temperature using two water pasteurizers (WP1 and WP2) and one air pasteurizer (AP). METHODS: The milk temperature during each phase of the pasteurization cycle was recorded using 6 to 9 probes, depending on the number of bottles, in the pasteurizers. We used 90 to 200 ml bottles to assess the effect of volume on milk temperature. RESULTS: The time to heat the milk from room temperature to 58°C was 12.4, 12.9, and 64.5 min, respectively, for WP1, WP2, and the AP ( p < .0001). The duration of the plateau was 35.5, 35.2, and 45.8 min ( p < .0001). The duration of exposure to a temperature above 58°C was 49.6, 40.7, and 76.2 min ( p < .0001). The total duration of a full cycle was 79, 66, and 182 min ( p < .0001). The duration of exposure above 58°C for the different volumes of milk treated showed no difference when using WP1 but was significantly longer in small volumes when using WP2. CONCLUSION: Human milk treated using the air pasteurizer in our study was exposed to higher temperatures and for longer periods of time than the water pasteurizers we employed. Regular qualification of pasteurizers is requested when evaluating the effect of pasteurization on milk components and for routine treatment of human milk in milk banks.