ABSTRACT
OBJECTIVE: To evaluate the relationship between preterm premature rupture of membranes (PPROM) and cognitive impairment in 5-year-old children born very preterm. STUDY DESIGN: The Etude Epidémiologique sur les Petits Ages Gestationnels Study is a population-based cohort of children followed up from birth to age 5 years recruited in 9 French regions in 1997. We analyzed data from singletons born between 24 and 32 weeks gestation categorized into 4 groups according to etiology of prematurity: infants born after PPROM, after idiopathic preterm labor, in a vascular context (Vasc), and to women with other complications (Other). Cognitive development at age 5 years was assessed using the Mental Processing Composite score of the Kaufman-Assessment Battery for Children. RESULTS: Among the 1051 children followed up to age 5 years, the mean Mental Processing Composite score was 93.6 ± 19.7, and 13.3% of the children (140 of 1051) had cognitive impairment. After adjustment for potential confounders, the risk of cognitive impairment among infants in the PPROM group was not significantly different than that in the idiopathic preterm labor group (OR, 1.09; 95% CI, 0.62-1.92) and the Other group (OR, 1.36; 95% CI, 0.75-2.47), but was lower than that in the Vasc group (OR, 1.86; 95% CI, 1.16-2.97). In the PPROM group, the risk of cognitive impairment was greater when the latency period (ie, time from rupture to delivery) was <3 days (OR, 2.32; 95% CI, 1.07-5.02). CONCLUSION: Preterm infants born after PPROM are not at increased risk for cognitive impairment in childhood, but the time between PPROM and birth may influence that risk.
Subject(s)
Cognition Disorders/etiology , Developmental Disabilities/etiology , Fetal Membranes, Premature Rupture , Child, Preschool , Cognition Disorders/epidemiology , Developmental Disabilities/epidemiology , Female , Gestational Age , Humans , Infant, Newborn , Infant, Premature , Male , Pregnancy , Prospective StudiesABSTRACT
Introdução: Manchas vinho do Porto (MVP) são malformações vasculares presentes ao nascimento que podem causar alterações emocionais no paciente conforme sua localização. Tratamentos com luz intensa pulsada (LIP) e outros tipos de lasers têm sido relatados com respostas variadas. Objetivos: Revisão da literatura sobre opções terapêuticas utilizando fontes de luz nas MVP e demonstração de tratamento bem-sucedido com LIP associada a laser Nd:YAG. Método: Paciente feminina, de 14 anos, apresentando MVP na região supralabial foi tratada com a associação de laser Nd:YAG 1064nm e LIP 560nm. Foram realizadas 8 sessões com, em média, 30 dias de intervalo entre elas. Estudo realizado na Clínica Dermatológica Célia Kalil. Resultado: A paciente obteve total desaparecimento da MVP na área tratada, com o mínimo de efeitos adversos. Conclusão: A associação de LIP 560nm e laser Nd:YAG 1064nm parece ser uma alternativa adequada no tratamento das MVP.
Introduction: Port wine stains (PWS) are vascular malformations present at birth, and, depending on their location, they can cause emotional changes in the patient. Studies on the treatment of PWS with intense pulsed light (IPL) and other types of lasers presented different responses. Objectives: The objective of this study was to review the literature on the treatment options of PWS with light sources, demonstrating the success of IPL associated with Nd:YAG laser. Method: A 14 years old female patient with PWS in the supralabial region was treated with the association of 1064- nm Nd:YAG laser and 560-nm IPL. She underwent eight treatment sessions with a mean interval of 30 days between each session. The study was conducted at the Célia Kalil Dermatology Clinic. Result: The port wine stains disappeared completely with a very low incidence of adverse events. Conclusion: The association of 560-nm IPL and 1064-nm Nd:YAG laser seemed an adequate treatment alternative for PWS.