To determine whether birth and care in the highest-level hospitals (level III) compared with birth in or postnatal transfer to lower-level hospitals (level II) are associated with 5-year morbidity in very preterm children.
A cohort study.
All surviving 5-year-old children born very preterm (gestational age
To evaluate the amount of antenatal care days in level III hospitals caused by regionalization of very preterm deliveries.
We included all 171,997 pregnancies registered in Finland between January 1, 2004 and December 31, 2006. Data on deliveries from the Medical Birth Register were linked to the Hospital Discharge Register. Maternal zip codes were used to define whether a mother lived inside or outside a level III hospital region. Regionalization was defined as care in level III hospitals between gestational weeks 22 and 32 among mothers living outside level III hospital regions. Pregnancies were divided into 3 groups based on the gestational age at delivery: very preterm (
ABSTRACTThe emergence of grammar in relation to lexical growth was analyzed in a sample of Finnish children (N=181) at 2 ; 0. The Finnish version of the Communicative Development Inventory was used to gather information on both language domains. The onset of grammar occurred in close association with vocabulary growth. The acquisition of the nominal and verbal inflections of Finnish differed when analyzed in relation to the lexicon in which they are used: the strongest growth in the acquisition of case form types occurred when the nominal lexicon size was roughly between 50 and 250 words, whereas verb inflectional types were acquired actively from the beginning of the verb lexicon acquisition. The findings extend the previous findings of the close association between lexicon and grammar (e.g. Bates & Goodman, 1999). The results suggest that different grammatical structures display different degrees and types of lexical dependency.
Altered brain volumes and associations between volumes and developmental outcomes have been reported in prematurely born children.
To assess which regional brain volumes are different in very low birth weight (VLBW) children without neurodevelopmental impairments ([NDI] cerebral palsy, hearing loss, blindness and significantly delayed cognitive performance) compared with VLBW children with NDI, and to evaluate the association between regional brain volumes at term-equivalent age and cognitive development and neurological performance at a corrected age of 2 years.
The study group consisted of a regional cohort of 164 VLBW children, divided into one group of children without NDI (n?=?148) and one group of children with NDI (n?=?16). Brain (MRI) was performed at term-equivalent age, from which brain volumes were manually analysed. Cognitive development was assessed with the Bayley Scales of Infant Development II (BSID-II), and neurological performance with the Hammersmith Infant Neurological Examination at the corrected age of 2 years.
The volumes of total brain tissue, cerebrum, frontal lobes, basal ganglia and thalami, and cerebellum were significantly smaller, and the volume of the ventricles significantly larger, in the children with NDI than in those without NDI. Even in children without NDI, a smaller cerebellar volume was significantly correlated with poor neurological performance at 2 years of corrected age.
Volumetric analysis at brain MRI can provide an additional parameter for early prediction of outcome in VLBW children.
The place and time of birth influence the mortality of premature infants. We studied the effect of prematurity, time of birth, birth hospital level and district on the development and behaviour in a national cohort of 5-year-old Finnish very low birthweight infants (VLBWI). All surviving VLBWI (gestational age
To investigate the effect of maternal, infant and birth hospital district related factors on the length of initial hospital stay in very preterm infants. In addition, rehospitalization rate within the first year from the initial discharge was studied.
A register study covering all very preterm infants (gestational age
the first aim of this two-phase study was to describe and compare, between two university hospitals, the early physical contact of mothers and their preterm or sick newborn infants in the delivery room. Secondly, the staff's perceptions of factors facilitating and promoting or impeding this contact were evaluated. Thirdly, the association between early physical contact and the initiation of breast feeding was examined.
a structured survey was conducted between November 2008 and March 2009 in two university hospitals in Finland.
in phase I, the sample consisted of all preterm or sick infants who needed NICU care and whose questionnaires were completed by labour ward staff (hospital A, n=178/185, hospital B, n=203/235). In phase II, a subsample of these infants (A, n=76, B, n=94) and their mothers who completed their questionnaires participated in the study.
structured questionnaires developed for this study were used.
the implementation of early physical contact differed between the study hospitals. The infants had physical contact with their mothers more often in hospital A than in hospital B whether they were sick full-term (83% versus 58%, p
It is not well understood how grammar emerges in very-low-birth-weight (VLBW) children. The main aim of the present study was to gain information on the emergence of grammar in this group at 2 ; 0. The Finnish version of the Communicative Development Inventory was used to collect data from VLBW children (N = 156) and full-term controls (N = 146). At a group level, the grammatical skills of the VLBW children were significantly weaker than those of the controls. However, when the effect of lexicon size and premature birth on the emergence of grammar was analyzed in detail, few significant differences were found between the groups. The results suggest that even though grammar emerges more slowly for the VLBW children, it emerges in a manner comparable to that of the controls, when the effect of lexicon size is taken into consideration.