The long-term outcome of extremely preterm (< 28weeks' gestational age) infants with and without severe retinopathy of prematurity

Background: Severe retinopathy of prematurity (ROP) is associated with an increased risk for ophthalmologic morbidity, but the long‐term impact in other domains is less clear. The aim of the current study was to determine whether severe ROP was related to poorer visual, cognitive, and educational outcomes in a representative sample of EP adolescents, and whether this persisted after adjusting for confounding neonatal risk factors. Method: One hundred and eighty extremely preterm (EP; <28 weeks) adolescents (17–18 years) were assessed on a range of neurodevelopmental measures, including visual processing, IQ, visual learning, visual‐motor integration, and academic achievement. EP adolescents were grouped according to ROP status, (1) severe ROP (stage 3 or greater) in the worse eye; or (2) no or mild ROP and were compared on each outcome. Longitudinal data were compared at 2, 5, 8, and 17–18 years for general cognitive outcome. Results: The severe ROP group performed more poorly and had more impairments than the non‐severe ROP group on measures of visual processing, visual‐motor integration, visual learning, IQ, and some academic achievement tests at 17–18 years of age. Group differences diminished after controlling for perinatal risk factors (severe white matter injury, post‐natal corticosteroid, and surgery in the neonatal period), and only visual acuity scores remained significantly different between the groups. IQ scores remained consistently lower in the severe ROP group over time, but the magnitude reduced after adjusting for perinatal risk factors. Conclusions: Extremely preterm children with severe ROP are at increased risk for ongoing visual processing difficulties and lower IQ compared with EP peers without severe ROP. While severe ROP is a predictor of long‐term impairments, this association is largely mediated by other neonatal risk factors.Carly S. Molloy, Peter J. Anderson, Vicki A. Anderson, Lex W. Doyl

Visual processing in adolescents born extremely low birth weight and/or extremely preterm

BACKGROUND AND OBJECTIVES: Ocular growth and development differs between preterm and term-born infants and may cause longterm negative consequences for visual function, but contemporary data on long-term visual outcomes in representative samples of the highest risk extremely low birth weight (ELBW, ,1000 g birth weight) or extremely preterm (EP, ,28 weeks’ gestation) survivors are lacking. Our objective was to compare visual functioning between ELBW/EP and normal birth weight (NBW, .2499 g birth weight) control adolescents. METHODS: Geographically determined cohort study of 228 consecutive ELBW/EP survivors born in the state of Victoria in 1991 and 1992, and 166 randomly selected NBW controls assessed between 14 and 20 years of age. Visual acuity, stereopsis, convergence, color perception, and visual perception were assessed and contrasted between groups. RESULTS: ELBW/EP subjects had significantly worse visual acuity with habitual correction in both the left and right eyes, and for the best eye (P , .001). The ELBW/EP adolescents also exhibited poorer stereopsis, odds ratio (OR) 3.22 (95% confidence interval [CI] 1.78 to 5.84), and convergence, OR 2.76 (CI 1.32 to 5.75) than controls, and more problems with visual perception, OR 3.09 (CI 1.67 to 5.71) after habitual correction. CONCLUSIONS: Despite advances in medical care improving the survival rate of high-risk ELBW/EP infants, visual morbidity is still relatively high compared with controls in late adolescence.Carly S. Molloy, Michelle Wilson-Ching, Vicki A. Anderson, Gehan Roberts, Peter J. Anderson, Lex W. Doyle, for the Victorian Infant Collaborative Study Grou

Formation of antimony sulfide powders and thin films from single-source antimony precursors

10.1039/b810947hJournal of Materials Chemistry18445399-5405JMAC

Attention difficulties in a contemporary geographic cohort of adolescents born extremely preterm/extremely low birth weight

The aim of this study was to evaluate attention difficulties in a contemporary geographic cohort of adolescents born extremely preterm (EP, 2499 g) who were recruited in the newborn period and matched to the EP/ELBW group on date of birth, gender, language spoken and health insurance status. Participants were assessed on measures of selective, sustained, and executive (shift and divided) attention, and parents and participants completed behavioral reports. The EP/ELBW group performed more poorly across tests of selective and executive attention, had greater rates of clinically significant difficulties compared with the control group, and also had greater behavioral attention problems as reported by parents. Neonatal risk factors were weakly associated with attention outcomes. In conclusion, higher rates of attention impairments are observed in individuals born EP/ELBW well into adolescence and may have consequences for their transition to adulthood. (JINS, 2013, 19, 1–12)Michelle Wilson-Ching, Carly S. Molloy, Vicki A. Anderson, Alice Burnett, Gehan Roberts, Jeanie L.Y. Cheong, Lex W. Doyle and Peter J. Anderso

The contribution of visual processing to academic achievement in adolescents born extremely preterm or extremely low birth weight

Children born extremely preterm (EP, <28 weeks) and/or extremely low birth weight (ELBW, <1000 g) have more academic deficiencies than their term-born peers, which may be due to problems with visual processing. The aim of this study is to determine (1) if visual processing is related to poor academic outcomes in EP/ELBW adolescents, and (2) how much of the variance in academic achievement in EP/ELBW adolescents is explained by visual processing ability after controlling for perinatal risk factors and other known contributors to academic performance, particularly attention and working memory. A geographically determined cohort of 228 surviving EP/ELBW adolescents (mean age 17 years) was studied. The relationships between measures of visual processing (visual acuity, binocular stereopsis, eye convergence, and visual perception) and academic achievement were explored within the EP/ELBW group. Analyses were repeated controlling for perinatal and social risk, and measures of attention and working memory. It was found that visual acuity, convergence and visual perception are related to scores for academic achievement on univariable regression analyses. After controlling for potential confounds (perinatal and social risk, working memory and attention), visual acuity, convergence and visual perception remained associated with reading and math computation, but only convergence and visual perception are related to spelling. The additional variance explained by visual processing is up to 6.6% for reading, 2.7% for spelling, and 2.2% for math computation. None of the visual processing variables or visual motor integration are associated with handwriting on multivariable analysis. Working memory is generally a stronger predictor of reading, spelling, and math computation than visual processing. It was concluded that visual processing difficulties are significantly related to academic outcomes in EP/ELBW adolescents; therefore, specific attention should be paid to academic remediation strategies incorporating the management of working memory and visual processing in EP/ELBW children.Carly S. Molloy, Ashley M. Di Battista, Vicki A. Anderson, Alice Burnett, Katherine J. Lee, Gehan Roberts, Jeanie Ly Cheong, Peter J. Anderson si Lex W. Doyl