Prevention of Neurological Sequelae in Preterm Infants.

BACKGROUND: Preterm birth is one of the world's critical health problems, with an incidence of 5% to 18% of living newborns according to various countries. White matter injuries due to preoligodendrocytes deficits cause hypomyelination in children born preterm. Preterm infants also have multiple neurodevelopmental sequelae due to prenatal and perinatal risk factors for brain damage. The purpose of this work was to explore the effects of the brain risk factors and MRI volumes and abnormalities on the posterior motor and cognitive development at 3 years of age. METHODS: A total of 166 preterm infants were examined before 4 months and clinical and MRI evaluations were performed. MRI showed abnormal findings in 89% of the infants. Parents of all infants were invited to receive the Katona neurohabilitation treatment. The parents of 128 infants accepted and received Katona's neurohabilitation treatment. The remaining 38 infants did not receive treatment for a variety of reasons. At the three-year follow-up, Bayley's II Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI) were compared between treated and untreated subjects. RESULTS: The treated children had higher values of both indices than the untreated. Linear regression showed that the antecedents of placenta disorders and sepsis as well as volumes of the corpus callosum and of the left lateral ventricle significantly predicted both MDI and PDI, while Apgar < 7 and volume of the right lateral ventricle predicted the PDI. CONCLUSIONS: (1) The results indicate that preterm infants who received Katona's neurohabilitation procedure exhibited significantly better outcomes at 3 years of age compared to those who did not receive the treatment. (2) The presence of sepsis and the volumes of the corpus callosum and lateral ventricles at 3-4 months were significant predictors of the outcome at 3 years of age.

Programa de educación para padres sobre estimulación del desarrollo del lenguaje de lactantes prematuros con riesgo de daño cerebral / Parent education programme on stimulation of language development in preterm infants at risk of brain damage

Introducción: La interacción temprana madre-hijo es crítica para el desarrollo adecuado del lactante; sin embargo, la interacción de los padres con los lactantes prematuros presenta una dificultad particular por las circunstancias que acompañan un nacimiento prematuro, como son los factores de riesgo de daño cerebral, y la necesidad de estimulación temprana tanto motora como cognitiva que demandan estos bebés. Se ha observado que los programas educativos tienen efectos positivos en los padres de lactantes prematuros ya que mejoran los resultados de sus hijos en evaluaciones motrices, cognitivas y del lenguaje. Método: En este trabajo se examina el efecto de un programa de educación para padres para estimular el desarrollo de las habilidades comunicativas de los lactantes prematuros. Se examinó cómo cambió la interacción padres-hijo después del programa de intervención. Adicionalmente, se compararon los resultados de las evaluaciones de lenguaje de los niños, hijos de los padres que participaron en el programa de intervención comparados con niños pares, hijos de padres que no participaron en dicho programa. Resultados: El programa contribuyó a cambiar la interacción de los padres con los lactantes y a mejorar los puntajes en las evaluaciones posteriores del lenguaje de sus hijos. Conclusión: Se recomienda la participación de los padres de niños prematuros en programas de educación para padres para estimular el desarrollo del lenguaje de sus hijos

Introduction: Early mother-child interaction is critical for proper infant development; however, the interaction of parents with preterm infants presents a particular difficulty due to the circumstances that accompany premature birth, such as risk factors for brain damage and the early motor and cognitive stimulation that these infants demand. It has been observed that educational programmes have positive effects on the parents of preterm infants as they improve the outcomes of their children in motor, cognitive and language assessments. Method: This paper examines the effect of a parent education programme designed to stimulate the development of the early communicative skills of preterm infants. We examined how the parent-child interaction changed following the intervention programme. In addition, the results of the language evaluations of the children whose parents participated in the intervention programme and those whose parents did not participate were compared. Results: The programme helped to change the interaction of parents with their infants and to improve scores in the children's subsequent language assessments. Conclusion: Parents of premature children are encouraged to participate in parent education programmes to encourage the development of their child's language abilities

Uso del Inventario de Habilidades Comunicativas de MacArthur-Bates con lactantes en riesgo de daño cerebral / Use of the MacArthur-Bates-Communicative-Inventory with infants at risk of brain damage

Introducción. Existen escasas pruebas conductuales validadas para hispanoparlantes que incluyen dentro de sus normas lactantes normo-oyentes con riesgo de daño cerebral perinatal. Sin medidas conductuales validadas, los clínicos usan pruebas que no están normadas para esta población, como el Inventario de Habilidades Comunicativas MacArthur-Bates (SCDI). Estudios electrofisiológicos han mostrado que las subpruebas comprensión y producción de palabras de dicho inventario tienen un alto poder discriminante en estas poblaciones en riesgo cuando se ajusta la norma de la prueba al percentil 50. Se examinó dicha norma ajustada en la práctica clínica. Método. Diseño de un solo grupo y selección de la muestra semialeatoria. Se seleccionaron 30 niños con factores de riesgo de daño cerebral perinatal de la Unidad de investigación en Neurodesarrollo a los que se les hubiera aplicado el inventario al año de edad y la Escala de Lenguaje Preescolar (PLS-5) entre los 3 y 4 años. Se comparó la proporción de niños identificados con alteraciones en el desarrollo del lenguaje por la PLS-5 entre los 3-4 años con la proporción de niños identificados con riesgo por el SCDI al año de edad usando la norma sin ajustar y la norma ajustada. Resultados. La norma ajustada del SCDI permitió identificar una proporción de niños con riesgo del lenguaje al año de edad similar a la proporción que se identificó con alteraciones entre los 3 y 4 años. Conclusión. Debería considerarse una norma ajustada cuando se examinen poblaciones con riesgo de daño cerebral usando el Inventario SCDI al año de edad

Introduction. There are few validated language test for Spanish speakers that cover normo-listeners infants at risk of brain damage. Without validated behavioural measures, clinicians use test that are not standardised for this population, such as the MacArthur-Bates Communicative Skills Inventory (SCDI). Electrophysiological studies have shown that the comprehension and word production sub-test of such inventory have high discriminatory power in these at-risk populations when the test standard is adjusted to the 50th percentile. This adjusted standard was examined in clinical practice. Methods. Design of a single group and selection of the semi-random sample. We selected 30 infants at risk of brain damage from the Neurodevelopment Research Unit to which the Inventory at one year old and the Preschool Language Scale (PLS-5) were applied between the ages of 3 and 4 years. We compared the proportion of children identified with language developmental impairments by PLS-5 between the ages of 3-4 with the proportion of children identified at risk by SCDI at one year of age using the non-adjusted norm and adjusted norm. Results. The adjusted SCDI standard allowed the identification of a proportion of infants at risk of brain damage and also at risk of language development impairments at one year of age, similar to the proportion that was identified with impairments between 3 and 4 years. Conclusion. An adjusted norm should be considered when examining infants at risk of brain damage using the SCDI Inventory at one year of age