A systematic review of studies reporting risk factors for cerebral palsy and motor impairment in very preterm children has been published in Developmental Medicine & Child Neurology. The review, by NPEU researchers Louise Linsell, Reem Malouf, Jenny Kurinczuk and others, identified 28 articles published over two decades. The primary prognostic risk factors identified were major brain ultrasound abnormalities, male sex, antenatal corticosteroids (which predicts a lower risk) and postnatal steroids (which predicts a higher risk). Read the paper and the related editorial.
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A systematic review reporting long term cognitive problems and school outcomes in children born just a few weeks early has been published in Child: Care Health and Development. The review, led by a team including NPEU researchers Maria Quigley and Reem Malouf, included fourteen studies of children who were born late preterm (34-36 weeks' gestation) and eight studies of children born early term (37-37 weeks' gestation), and identified multiple, small, adverse differences between children born late preterm or early term compared with those born at term. Read the abstract of the paper.
The long awaited results from the landmark BOOST-II UK trial have been published in the New England Journal of Medicine. The article, entitled "Outcomes of Two Trials of Oxygen-Saturation Targets in Preterm Infants” reports the outcomes at 2 years (after their expected date of delivery) for babies who participated in the BOOST-II UK and the BOOST-II Australia trials. Read the paper.
Infant pain has both immediate and long-term negative consequences, yet in clinical practice it is often under-treated and very few pain-relieving drugs have been tested in babies. The Poppi Trial has been designed to test whether morphine can provide effective pain relief in babies during invasive medical procedures. Led by Dr Rebeccah Slater in collaboration with the NPEU and the Paediatric and Infant Pain & Anaesthesia (PiPA) group, the trial is due to start recruitment at the John Radcliffe Hospital in Oxford in Spring 2016. Read the summary protocol published in the Lancet for more information.
The NPEU Clinical Trials Unit is collaborating with the University of Aberdeen on a large-scale multi-centre trial comparing the use of ‘fresh’ and frozen embryos for IVF, the first of its kind in the UK. E-Freeze, funded by the NIHR Health Technology Assessment (HTA) Programme will recruit 1,086 couples to see which method produces the greatest number of healthy babies, as well as considering the health of the mother and costs to the health services and longer-term societal costs. News about the trial has featured in The Scotsman and The Herald newspapers. Read more about E-Freeze.
A systematic review of studies reporting models for predicting behavioural problems or psychiatric disorders in very preterm children has been published in the Journal of Developmental and Behavioral Pediatrics. The review, by NPEU researchers Louise Linsell, Reem Malouf, Jenny Kurinczuk and others identified 15 articles published over two decades, but revealed a lack of evidence for any risk factors. The review concluded that there is a need for further research using large, well-conducted studies with standard diagnostic evaluations in school-age children and adolescents born very preterm. Read the abstract of the paper.
A paper exploring the risk of psychological stress in parents of babies born preterm has been published in BMJ Open. The study, by Claire Carson, Maggie Redshaw, Ron Gray and Maria Quigley, analysed data on 12,100 families recruited into the Millennium Cohort Study, including 7% who had experienced a preterm birth. Overall, 12% of mothers and 9% of fathers showed signs of psychological distress at 9 months postpartum. These prevalences were increased in parents of very preterm infants and mothers of infants born at early term (gestation 37-38 weeks). Full details can be found on the BMJ website.
Babies born at 36 weeks’ gestation or more, who had signs of moderate or severe neonatal encephalopathy following lack of oxygen, were eligible for this trial, which recruited from February 2012 to September 2014. All babies were treated with moderate hypothermia, which had to start within 6 hours of age. Parental consent was sought to allow randomisation by 12 hours of age to standard cooling treatment alone or standard cooling treatment plus inhaled 30% xenon gas, delivered via a neonatal ventilator for 12 hours. Cooling treatment lasted for 72 hours followed by gradual rewarming.
Adding inhaled xenon treatment to moderate cooling for term infants who have experienced lack of oxygen at birth, was shown to be safe during this phase II clinical trial. However, xenon plus cooling treatment did not provide added neuroprotective benefit over cooling treatment alone.
The TOBY Xenon Study was funded by the Medical Research Council, and its sponsor was Imperial College London.
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