Health related quality of life of former very preterm infants in adulthood

Aim:  To assess health related quality of life of young adults born very preterm compared with a term control group. Methods:  A cohort of preterm infants <1250 g and a term control group, both born between 1983-1985, were surveyed as adults at the median age of 23 years. Questionnaires including the SF 36 and a modified lifestyle questionnaire assessed quality of life, health attitudes, height and weight, chronic diseases, medication and drug consumption. Results:  52 preterms and 75 controls matched for age and sex participated in the study. There were no significant differences in the quality of life as assessed by SF 36. Former preterms were significantly smaller than their term controls but not so for body mass index. The overall consumption of illicit drugs was significantly lower in former preterms. Moreover, former preterms went significantly less often in for sports. There was a trend for higher prevalence of chronic diseases in male compared to female preterms, but their use of medication was significantly lower. Conclusion:  Adults, born very preterm show no significant differences in their quality of life when compared to controls in early adulthood. However, based on their lifestyle and health disadvantages, male preterm subjects constitute a risk group when entering early adulthood with a clear need for continued attention

Distal humeral epiphyseal separation

Distal humeral epiphyseal separation is a rare orthopedic condition of the newborn (incidence 1:35'000) that requires immediate surgical correction. Untreated, the condition can lead to elbow cubitus varus deformity or dysfunction (1, 2). Diagnosis is challenging as the condition can be easily overlooked or misinterpreted as a brachial plexus palsy or an elbow dislocation. We present the case of a newborn patient whom we treated in multidisciplinary collaboration with our colleagues at the Department of Pediatric Orthopedic and Trauma Surgery and Radiology at the University Children’s Hospital of Zurich

Improved radiological assessment of neonatal feeding tubes

BACKGROUND: In about one-fifth of radiographs performed in neonates, no exact gastric feeding tube position can be defined. OBJECTIVES: To determine whether injection of air via feeding tube before taking radiographs improves radiological assessment of its position. METHODS: In the study group (n=153), air was injected via gastric feeding tube before taking a radiograph. The tube position on radiographs was compared with a blinded control group (n=381) with no injection of air. RESULTS: The definition of exact gastric tube position was possible in 95% of the study group compared with 78% in the control group (p<0.001). CONCLUSION: Injection of air before taking a radiograph significantly improves the definition of exact gastric feeding tube position in neonates

Impact of sepsis on neurodevelopmental outcome in a Swiss national cohort of extremely premature infants

OBJECTIVE: Neonatal sepsis causes high mortality and morbidity in preterm infants, but less is known regarding the long-term outcome after sepsis. This study aimed to determine the impact of sepsis on neurodevelopment at 2 years' corrected age in extremely preterm infants. PATIENTS AND METHODS: This was a multicenter Swiss cohort study on infants born between 2000 and 2007 at 24 0/7 to 27 7/6 weeks' gestational age. Neurodevelopmental outcome was assessed with the Bayley Scales of Infant Development-II. Neurodevelopmental impairment (NDI) was defined as a Mental or Psychomotor Developmental Index lower than 70, cerebral palsy (CP), or visual or auditory impairment. RESULTS: Of 541 infants, 136 (25%) had proven sepsis, 169 (31%) had suspected sepsis, and 236 (44%) had no signs of infection. CP occurred in 14 of 136 (10%) infants with proven sepsis compared with 10 of 236 (4%) uninfected infants (odds ratio [OR]: 2.90 [95% confidence interval (CI): 1.22-6.89]; P = .016). NDI occurred in 46 of 134 (34%) infants with proven sepsis compared with 55 of 235 (23%) uninfected infants (OR: 1.85 [95% CI: 1.12-3.05]; P = .016). Multivariable analysis confirmed that proven sepsis independently increased the risk of CP (OR: 3.23 [95% CI: 1.23-8.48]; P = .017) and NDI (OR: 1.69 [95% CI: 0.96-2.98]; P = .067). In contrast, suspected sepsis was not associated with neurodevelopmental outcome (P > .05). The presence of bronchopulmonary dysplasia, pathologic brain ultrasonography, retinopathy, and sepsis predicted the risk of NDI (P < .0001). CONCLUSIONS: Proven sepsis significantly contributes to NDI in extremely preterm infants, independent of other risk factors. Better strategies aimed at reducing the incidence of sepsis in this highly vulnerable population are needed