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[S27]: Relation of blood oxygenation in the first hours of life and school age outcomes in “healthy” children born at very low birthweight
Author(s) -
Smith K.E.,
Keeney S.E.,
Susabda A.,
Rassin D.K.,
Kent T.A.,
Fabian R.H.,
PerezPolo R.
Publication year - 2006
Publication title -
international journal of developmental neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.761
H-Index - 88
eISSN - 1873-474X
pISSN - 0736-5748
DOI - 10.1016/j.ijdevneu.2006.09.034
Subject(s) - medicine , gerontology , medical school , pediatrics , medical education
Most children born with very low birthweight (VLBW, 1500 g) are ‘‘healthy’’ (80%), but remain at increased risk for ‘‘subtle dysfunctions’’ that become more apparent at school ages (Aylward, 2003). Yet predictors of dysfunction are unknown. In animal models, increased blood oxygen very early in life rapidly produces reactive oxygen species that link to brain abnormalities in regions that correlate with the deficits found in VLBW children (Hu et al., 2003; Qiu et al., 2004). Parenting can also have a significant impact on skill development (Smith et al., 2006). Translational research has not been conducted to determine if relations evident in animal models are evident in a clinical population and if responsive parenting serves as a ‘‘protective’’ factor. Methods: Subjects were from a cohort of 52 ‘‘healthy’’ children born at VLBW in 1991/92 with 40 followed from 6 mos into school age. Of these, 36 had a PaO2 documented in the first 4 h of life. To ensure a ‘‘healthy’’ sample, a neonatologist reviewed medical records to exclude those with severe problems in the perinatal or neonatal history that could negatively impact development. Parenting quality was evaluated during home visits at 6, 12, and 24 mos using observational methods. At 4, 6, 8, and 10 years of age, children’s attention, impulse control, executive functions, and motor skills were measured using standardized tests. Results: Higher PaO2 predicted greater difficulty with motor skills and executive function with trends for greater difficulty with attention and impulse control found. Significant interactions with parenting suggested that children who experienced less responsive parenting and greater hyperoxygenation had the poorest outcomes. Discussion: While replication with a larger sample is needed, these results suggest that hyperoxygenation in healthy infants may predict ‘‘subtle dysfunctions’’ and these may be exacerbated by less responsive caregiving. Although, current clinical care has moved to lower levels of oxygen during resuscitation, the optimum dose is not yet known and further research is needed.