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Gäddlin, Per-Olof
Publications (10 of 16) Show all publications
Gäddlin, P.-O., Finnström, O., Wang, C. & Leijon, I. (2008). A fifteen-year follow-up of neurological conditions in VLBW children without overt disability: Relation to gender, neonatal risk factors, and end stage MRI findings. Early Human Development, 84(5), 343-349.
Open this publication in new window or tab >>A fifteen-year follow-up of neurological conditions in VLBW children without overt disability: Relation to gender, neonatal risk factors, and end stage MRI findings
2008 (English)In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 84, no 5, 343-349 p.Article in journal (Refereed) Published
Abstract [en]

Background: Very low birthweight (VLBW; birth weight ≤ 1500 g) children run a greater risk than controls of developing neurosensory disabilities, but also minor neurological disturbances.

Aims: To assess neurological status from the neonatal period up to fifteen years of age in VLBW children without overt neurological disability in relation to gender, neonatal risk factors, and Magnetic Resonance Imaging (MRI) findings of the brain.

Study design: A population based follow-up study of VLBW children and their controls.

Subjects: Eighty VLBW children without overt disability, in a cohort of 86 surviving VLBW children, were enrolled in a follow-up study at 40 weeks gestational age and at 4, 9, and 15 years of age. 56 VLBW children were examined with cerebral MRI at 15 years of age.

Outcome measures: Neurological test scores. MRI findings, principally white matter damage (WMD).

Results: VLBW children were inferior in neurological assessments in comparison with controls at 40 weeks gestational age and 4 and 15 years of age. VLBW girls did not differ from their controls at 9 and 15 years. Fourteen of 56 (25%) VLBW children had abnormal MRI findings and 13 were evaluated as mild WMD. Children with WMD did not differ in neurological outcome from those without WMD at any examination. Mechanical ventilation and/or intraventricular haemorrhage (IVH) during the neonatal period were significantly related to less a favourable outcome at follow-up examinations.

Conclusion: A cohort of VLBW children without overt neurological disability had a poorer neurological condition up to adolescence in comparison with controls. A quarter of the VLBW children had mild WMD but without relation to the neurological functions. Mechanical ventilation and IVH were related to poorer neurological outcome.

Place, publisher, year, edition, pages
Elsevier, 2008
Keyword
Very low birthweight infants, Follow-up study, Magnetic Resonance Imaging, Neurological function, Neonatal risk factors
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-15485 (URN)10.1016/j.earlhumdev.2007.09.013 (DOI)
Available from: 2008-12-04 Created: 2008-11-11 Last updated: 2017-12-14Bibliographically approved
Gäddlin, P.-O., Finnström, O., Samuelsson, S., Wadsby, M., Wang, C. & Leijon, I. (2008). Academic achievement, behavioural outcomes and MRI findings at 15 years of age in very low birthweight children. Acta Paediatrica, 97(10), 1426-1432.
Open this publication in new window or tab >>Academic achievement, behavioural outcomes and MRI findings at 15 years of age in very low birthweight children
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2008 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, no 10, 1426-1432 p.Article in journal (Refereed) Published
Abstract [en]

Aim: To assess cognitive, academic, and behavioural functions in 15-year-old very low birthweight (VLBW) children and relate results to gender, neonatal risk factors, growth, and Magnetic Resonance Imaging (MRI) findings.

Methods: 61/86 VLBW children and 57/86 term controls born in the south-east region of Sweden were assessed regarding cognition (WISC III), school outcome, behaviour, and growth. VLBW children were examined using cerebral MRI.

Results: VLBW children performed significantly lower than their term controls on WISC III and 49% had IQ lower than 85. Ten VLBW children with IQ <70 had not been clinically identified earlier and a majority of these children attended mainstream school. VLBW girls had significantly lower total problems scores. Using MRI, white matter damage (WMD) was detected in 16 (27%) children. VLBW boys with WMD had significantly lower IQ than those without. Small occipito-frontal circumference correlated with low IQ. Mechanical ventilation and intraventricular haemorrhage (IVH) showed significant correlations with lower IQ and reading skills.

Conclusion: VLBW children achieved poorer results compared with their controls in cognitive tests. Mechanical ventilation and IVH were related to poorer academic outcome. Many of the children with low IQ had not been identified earlier. Therefore, we recommend that VLBW children undergo an IQ test before beginning school in order to receive adequate support.

Keyword
Cognitive function, MRI findings, Neonatal risk factors, School performance, Very low birthweight infants
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-15486 (URN)10.1111/j.1651-2227.2008.00925.x (DOI)
Available from: 2008-12-04 Created: 2008-11-11 Last updated: 2017-12-14Bibliographically approved
Gäddlin, P.-O. (2008). Long-term follow-up of very low birthweight children: A prospective study from the southeast region of Sweden. (Doctoral dissertation). Linköping: Linköping University Electronic Press.
Open this publication in new window or tab >>Long-term follow-up of very low birthweight children: A prospective study from the southeast region of Sweden
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The survival rates for very low birthweight (VLBW; birthweight ≤1500 g) children are increasing, but they run a greater risk than controls of developing neurosensory disabilities and other functional problems during childhood. However, there is a great need for more knowledge regarding long-term outcome to adulthood in VLBW subjects.

Aims: To evaluate long-term outcomes in a regional cohort of VLBW children born in 1987-88 regarding hospital readmissions, morbidity, neurological conditions, cognitive function, reading skills, school achievements, behaviour, growth, general health, and social functioning in relation to gender, neonatal risk factors, disability and Magnetic Resonance Imaging (MRI) findings.

Study design: Prospective longitudinal case-controlled long-term regional follow-up.

Material and Methods: A total of 86 (80.4%) children (47 boys out of 60 and 39 girls out of 47 live-borns) survived the neonatal period and were recruited to the follow-up study. A total of 86 term controls (45 boys and 41 girls) were included from the newborn period. Readmissions, hospital diagnoses, need of habilitation and child psychiatric care were checked in registers to 15 years of age. The VLBW children were enrolled in the follow-up study at 40 weeks gestational age and at 4, 9, and 15 years of age in assessing neurological conditions. At 15 years of age, the groups were assessed in cognition (WISC III), reading skills, school outcome, behaviour, vision and growth. Fifty-nine (69%) VLBW children were examined using cerebral MRI. Physical and mental health, weight and height, education, and socio-economic situation were assessed at 20 years of age in 77/85 VLBW and 69/84 control subjects by means of postal questionnaires.

Results: VLBW boys had three times more readmissions compared with control boys (p=0.003). Gestational age below 30 weeks, birthweight less than 1000 g, and mechanical ventilation were neonatal risk factors for readmissions. Five (5.8%) children had moderate/severe cerebral palsy, 5 (5.8%) had attention deficit hyperactivity disorder, and 1 was blind due to retinopathy of prematurity.

VLBW children were inferior in neurological function in comparison with controls at 40 weeks of gestational age and 4 and 15 years of age. Fourteen of 56 (25%) VLBW children without overt disability had abnormal MRI findings. Mechanical and/or intraventricular haemorrhages (IVH) were significantly related to less favourable neurological outcome. VLBW children performed significantly lower than their controls on a few reading variables and on WISC III. Half of them had IQ lower than 85. Ten VLBW children with IQ < 70 had not been clinically identified earlier and a majority of these children attended mainstream school. Small head circumference correlated with low IQ. Mechanical ventilation and IVH correlated with lower IQ and poorer reading skills. At 20 years of age, the VLBW subjects did not differ significantly from the controls in self-perceived health, education, occupation and way of living.

Conclusions: Most VLBW subjects were without major health problems up to 20 years of age and had attended mainstream schools. The presence of IVH and mechanical ventilation during the neonatal period negatively influenced health outcomes. VLBW children without overt neurological disability performed somewhat less well in neurological examinations in comparison with controls. VLBW children achieved poorer results in cognitive tests, but reading skills made a catch-up to 15 years of age. A majority of VLBW subjects managed transition to adulthood similar to that of controls.

Abstract [sv]

Bakgrund: Överlevnaden för nyfödda barn med mycket låg födelsevikt (1500 g eller lägre; VLBW) har ökat avsevärt under de senaste årtionden och man finner nu att ca 90 % av barnen skrivs ut från neonatalavdelningar. Risken för cerebral pares (CP) har visat sig vara ökad jämfört med barn födda i fullgången tid. Studier visade att VLBW-barn som kommit upp i skolåldern hade högre frekvens av läs- och skrivsvårigheter, oftare behövde specialundervisning, samt hade högre grad av beteendeproblem jämfört med klasskamrater.

Uppföljningsstudier var tidigare mestadels gjorda på populationer från större sjukhus, kontrollgrupp saknades eller inlemmades efter flera år, uppföljningstiden var kort och flera viktiga områden av barnets utveckling var ofullständigt undersökta. I Sverige saknades en studie med långtidsuppföljning av VLBW-barn födda under en tidsperiod då alltfler barn hade börjat erhålla andningshjälp med respirator. Socioekonomiska förhållanden i Sverige kan inte heller helt och hållet jämföras med flertalet andra länder.

Syfte: Den här avhandlingens syfte var att studera hur det går för VLBW-barn upp till 15 års ålder avseende sjuklighet, motoriska funktioner, kognitiva funktioner, skolprestationer och beteende, samt vid 20 års ålder avseende hälsotillstånd, sysselsättning och boende. Undersökningsresultaten relaterades till nyföddhetsfaktorer och fynd vid magnet resonans-undersökning (MRI) av hjärnan vid 15 års ålder.

Material och metoder: 86 överlevande VLBW-barn samt 86 barn födda i fullgången tid från 1/2 1987 till 30/4 1988 i sydöstra sjukvårdsregionen (Jönköpings, Kalmar och Östergötlands län) har ingått i studien. Uppgift om antalet sjukhusinläggningar och huvuddiagnos inhämtades från Slutenvårdsregistret, Epidemiologiskt centrum, Socialstyrelsen. Uppgifter om antalet barn med CP, ADHD, mental retardation och barnpsykiatriskt vårdbehov inhämtades från habiliteringscentraler och barnpsykiatriska kliniker i regionen. Information om skolbetyg från 9:e årskursen och skolgång inhämtades från kommunerna. Neurologiska och motoriska undersökningar utfördes på barn utan synligt handikapp enligt särskilda protokoll såväl neonatalt som vid 4, 9 och 15 års ålder. Vikt och längd, kognitiv test (WISC III), lästester och MRI undersökning (enbart VLBW-barn) gjordes vid 15 års ålder. Barn och föräldrar fick fylla i formulär om beteende. Vid 20 års ålder (december 2007) fick deltagarna tre frågeformulär: ett studiespecifikt med frågor om hälsa, vikt och längd, användning av tobak och alkohol, gymnasiestudier, nuvarande sysselsättning och boende; SF-36, som belyser fysisk kapacitet, allmän hälsa, vitalitet och psykiskt välbefinnande; samt KASAM (känsla av sammanhang), som belyser hur man upplever sitt eget sätt att fungera, uppdelat i begriplighet, hanterbarhet och meningsfullhet.

Resultat: VLBW-barn (mest pojkar) vårdades oftare på sjukhus under första levnadsåren jämfört med kontroller. Infektioner och neurologiska sjukdomar dominerade för både VLBW-pojkar och -flickor. Fem (5.8 %) VLBW-barn hade måttlig/svår CP och fem hade ADHD. Hjärnblödning eller respiratorbehandling under nyföddhetsperioden var de faktorer som oftast var relaterade till sämre hälsotillstånd. Det var ingen skillnad i antal barn med behov av barnpsykiatrisk vård mellan grupperna. Det var ingen skillnad i summering av 9 slutbetyg mellan grupperna, men VLBW-pojkar hade lägre betyg i matematik och teknologi jämfört med sina kontroller. VLBW-barnen var lättare och kortare, men skillnaderna var störst mellan VLBW-flickor och deras kontroller. VLBW-barnen (fr.a. pojkarna) presterade lägre i neurologiska undersökningar, samt i kognitiva test. Tio av tolv av barnen som hade IQ under 70 var tidigare inte kända. Det fanns skillnader mellan grupperna i lästester, men signifikant enbart i ett test. Jämfört med lästester vid 9 års ålder hade VLBW-barnen gjort en upphämtning. Det framkom inga skillnader i beteende mellan grupperna, men VLBW-flickor uppgav färre beteendeproblem än sina kontroller. Vid 20 års ålder framkom inga skillnader i självuppskattad hälsa eller behov av vårdkontakter och läkemedel mellan grupperna. Tobaksanvändning var lika i grupperna, men fler i VLBW-gruppen var icke-användare av alkohol. Det var ingen signifikant skillnad i andel som gått ut gymnasiet, nuvarande sysselsättning eller boendeform mellan grupperna. Det var inga signifikanta skillnader i resultat på SF-36 och KASAM mellan grupperna.

Konklusion: Hjärnblödning och respiratoranvändning under nyföddhetsperioden var de faktorer som hade störst inverkan på VLBW-barnens hälsotillstånd upp till 20 års ålder. CP och ADHD förekom hos relativt få, men lågt IQ var vanligt. VLBW-pojkar hade större sjukvårdsbehov, presterade lägre i neurologiska test och hade lägre skolbetyg än sina kontroller. VLBW-gruppen skilde sig inte från kontroll-gruppen avseende beteendeproblem. Självuppskattad hälsa vid 20 år skilde sig inte mellan grupperna. Särskilda uppföljningsprogram för VLBW-barn är nödvändigt där kognitiva tester ingår vilka bör utföras före skolstart.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2008. 93 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1076
Keyword
Very low birthweight infants, Follow-up studies, Adolescence, Gender, Neonatal risk factors, Magnetic Resonance Imaging, Cognitive function, School performance, Health, Quality of Life
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-15492 (URN)978-91-7393-812-9 (ISBN)
Public defence
2008-10-10, Aulan, Länssjukhuset Ryhov, Länssjukhuset Ryhov, Jönköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2008-11-21 Created: 2008-11-12 Last updated: 2009-08-21Bibliographically approved
Roback, K., Gäddlin, P.-O., Nelson, N. & Persson, J. (2007). Adoption of medical devices: Perspectives of professionals in Swedish neonatal intensive care. Technology and Health Care, 15(3), 157-179.
Open this publication in new window or tab >>Adoption of medical devices: Perspectives of professionals in Swedish neonatal intensive care
2007 (English)In: Technology and Health Care, ISSN 0928-7329, Vol. 15, no 3, 157-179 p.Article in journal (Refereed) Published
Abstract [en]

Advances in biomedical engineering enable us to treat increasingly severe conditions. This implies an increased need for regulation and priority setting in healthcare, to ensure appropriate safety cautions and to avoid accelerating expenditures. This interview study investigates the mechanisms behind the adoption and use of medical devices through the subjective experiences of hospital staff working with devices for neonatal intensive care. The adoption was found to be primarily initiated by vendor activities, but professionals preferably sought information about functionality from close colleagues. Full integration of devices was sometimes not achieved, and even though the adopting units had good introduction routines, there was no systematic follow-up of how adopted devices had been integrated in the work practices. Diffusion variations were, however, mainly found for temporarily tested devices and not for permanently available technologies. Three factors were found to be the major explanatory variables of the adoption of medical devices: (1) the subjective expected value of the device, (2) information and learning, and (3) the innovativeness of the adopting unit.

Keyword
Diffusion, innovation, adoption, medical devices, neonatal intensive care, decision-making, healthcare management
National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-14143 (URN)130.236.83.89 (DOI)
Available from: 2006-11-13 Created: 2006-11-13 Last updated: 2009-05-12
Gäddlin, P.-O., Finnström, O., Hellgren, K. & Leijon, I. (2007). Hospital readmissions and morbidity in a fifteen-year follow-up of very low birthweight children in Southeast Sweden. Acta Paediatrica, 96(4), 499-505.
Open this publication in new window or tab >>Hospital readmissions and morbidity in a fifteen-year follow-up of very low birthweight children in Southeast Sweden
2007 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 4, 499-505 p.Article in journal (Refereed) Published
Abstract [en]

Aim: To study the effect of very low birthweight on hospital care and morbidity, and their relationship to gender, birthweight, and neonatal complications.

Methods: 85 very low birthweight (VLBW; ≤1500 g) children and term controls born in 1987-1988 in south-east region of Sweden were checked in registers regarding readmissions and diagnoses, need for habilitation and child psychiatric care up to 15 years of age. Ophthalmological examinations were made at age 4 in 64 of VLBW and 61 of control children, and at age 15 in 59 of VLBW and 55 of control children.

Results: VLBW boys had three times more readmissions compared with normal weight control boys (p=0.003). Neonatal risk factors for readmissions were gestational age under 30 weeks (OR 3.1), birthweight less than 1000 g (OR 4.6), mechanical ventilation (OR 9.5), and more than 60 days’ stay in neonatal ward (OR 5.0). A minority of VLBW children had an impairment/handicap such as cerebral palsy (CP) in five (5.9 %) children, attention deficit hyperactivity disorders (ADHD) in five children, and blindness due to retinopathy of prematurity in one child. One child in the control group had ADHD. At the 15-year examination median visual acuity in the best eye was better in the control group (1.6) than in the VLBW group (1.3) (p=0.009). 32% of VLBW children and 11% of controls had latent or manifest strabismus (p=0.007).

Conclusion: Risk factors for readmissions were gender, low gestational age, birthweight <1000 g or mechanical ventilation. A minority of VLBW children had a handicap that influenced their daily life activities at 15 years of age.

Place, publisher, year, edition, pages
Wiley InterScience, 2007
Keyword
Follow-up studies, Gender, Hospital readmission, Morbidity, Very low birth weight
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-15483 (URN)10.1111/j.1651-2227.2007.00183.x (DOI)
Available from: 2008-12-04 Created: 2008-11-11 Last updated: 2017-12-14Bibliographically approved
Samuelsson, S., Finnström, O., Flodmark, O., Gäddlin, P.-O., Leijon, I. & Wadsby, M. (2006). A longitudinal study of reading skills among very-low-birthweight children: Is there a catch-up?. Journal of Pediatric Psychology, 31(9), 967-977.
Open this publication in new window or tab >>A longitudinal study of reading skills among very-low-birthweight children: Is there a catch-up?
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2006 (English)In: Journal of Pediatric Psychology, ISSN 0146-8693, E-ISSN 1465-735X, Vol. 31, no 9, 967-977 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To examine the development of reading skills among very-low-birthweight (VLBW) children and to what extent reading difficulties at 9 years of age persist unchanged, are attenuated, or are enhanced at 15 years of age. Methods: Fifty-six VLBW and 52 normal birthweight (NBW) children were assessed on word decoding, word recognition, and reading comprehension at 9 and 15 years of age. Results: VLBW children showed deficits in reading skill at 9 years of age, while most differences obtained at 15 years of age did not reach significance. VLBW children improved their reading comprehension between 9 and 15 years of age more than NBW children, and when controlling for individual differences in IQ, VLBW children improved both their reading comprehension and word-recognition skill. Conclusion: The results suggest that VLBW children display positive changes over time in reading skills. © The Author 2006. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved.

Keyword
longitudinal study, low-birthweight, reading skills
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-34829 (URN)10.1093/jpepsy/jsj108 (DOI)23510 (Local ID)23510 (Archive number)23510 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Roback, K., Gäddlin, P.-O., Nelson, N. & Persson, J. (2006). Managing Technological Change in the Innovative Hospital: Experiences from Neonatal Intensive Care. In: World Congress on Medical Physics and Biomedical Engineering,2006. .
Open this publication in new window or tab >>Managing Technological Change in the Innovative Hospital: Experiences from Neonatal Intensive Care
2006 (English)In: World Congress on Medical Physics and Biomedical Engineering,2006, 2006Conference paper, Published paper (Refereed)
Abstract [en]

  

Keyword
Medical devices, Innovation, Neonatal
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-36962 (URN)33150 (Local ID)33150 (Archive number)33150 (OAI)
Available from: 2009-10-10 Created: 2009-10-10
Nelson, N., Orlenius, B., Bylund, B., Gäddlin, P.-O., Jonsson, N.-O., Ansved, P., . . . Fredriksson, M. (2006). Stora skillnader i vården av nyfödda vid åtta svenska BB-avdelningar. Läkartidningen, 103(1-2), 34-37.
Open this publication in new window or tab >>Stora skillnader i vården av nyfödda vid åtta svenska BB-avdelningar
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2006 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, no 1-2, 34-37 p.Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-31881 (URN)17711 (Local ID)17711 (Archive number)17711 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
Mai, X., Gäddlin, P.-O., Nilsson, L. & Leijon, I. (2005). Early rapid weight gain and current overweight in relation to asthma in adolescents born with very low birth weight. Pediatric Allergy and Immunology, 16(5), 380-385.
Open this publication in new window or tab >>Early rapid weight gain and current overweight in relation to asthma in adolescents born with very low birth weight
2005 (English)In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 16, no 5, 380-385 p.Article in journal (Refereed) Published
Abstract [en]

Early catch-up growth and subsequent overweight are suggested to be associated with later cardiovascular diseases and later type II diabetes. However, the impact of early catch-up growth and childhood overweight on the development of asthma has been less studied, particularly in children born with very low birth weight (VLBW). A birth cohort of 74 VLBW children (birth weight ≤ 1500 g) was followed from birth and investigated on asthma at 12 yr of age. Early rapid weight gain was in one way defined as an increase of weight ≥1 standard deviation score (SDS) at 6 months of corrected postnatal age. Current overweight was defined by body mass index (BMI) exceeding 21.2 and 21.7 kg/m2, respectively, for boys and girls at 12 yr of age. Current asthma was diagnosed by a pediatrician, according to asthma ever in combination with a positive response to hypertonic saline bronchial provocation test and/or wheeze at physical examination at 12 yr old. Being overweight at 12 yr of age was associated with an increased risk for current asthma in the VLBW children [crude odds ratio (OR): 5.5, 95% confidence interval (CI): 1.3-22.2]. After adjustment for early weight gain and neonatal risk, the OR of overweight increased nearly three times (adjusted OR: 15.3, 95% CI: 2.5-90.6). Early rapid weight gain seemed to be inversely associated with current asthma (adjusted OR: 0.49 for an increase of weight equal to 1 SDS, 95% CI: 0.23-1.02, p = 0.06). In addition, early rapid weight gain was inversely associated with the magnitude of bronchial responsiveness at 12 yr (coefficient -1.15, p < 0.01). There was a strong and positive association between overweight and asthma at 12 yr of age in the VLBW children. This strong association had been reduced by early rapid weight gain, possibly via the reduction of bronchial responsiveness. © 2005 Blackwell Munksgaard.

Keyword
asthma, early weight gain, infant, very low birth weight, overweight
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-30284 (URN)10.1111/j.1399-3038.2005.00290.x (DOI)15802 (Local ID)15802 (Archive number)15802 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
Mai, X., Gäddlin, P.-O., Nilsson, L., Finnström, O., Björkstén, B., Jenmalm, M. C. & Leijon, I. (2003). Asthma, lung function and allergy in 12-year-old children with very low birth weight: a prospective study. Pediatric Allergy and Immunology, 14(3), 184-192.
Open this publication in new window or tab >>Asthma, lung function and allergy in 12-year-old children with very low birth weight: a prospective study
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2003 (English)In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 14, no 3, 184-192 p.Article in journal (Refereed) Published
Abstract [en]

We assessed the relationship between very low birth weight (VLBW) (≤1500 g) and the development of asthma, lung function and atopy. The study groups comprised 74 of all 86 (86%) VLBW and 64 of all 86 (74%) matched term children who were prospectively followed for 12 years. A questionnaire on asthmatic and allergic symptoms was completed and skin prick tests, spirometry and hypertonic saline provocation tests were performed at 12 years of age. Cytokine secretion was analysed in stimulated blood leukocyte cultures in 28 VLBW and 23 term children. A history of asthma was more frequent among the VLBW children, as compared with the term children at age 12 (22% vs. 9%, p = 0.046). Among the VLBW children, very preterm birth (gestational age: week 25 to 29) (RR 2.5, 95%CI 1.1–5.8), neonatal mechanical ventilation (RR 2.8, 95%CI 1.2–6.4) and neonatal oxygen supplementation (RR 4.3, 95%CI 1.3–14.0) were significantly associated with a history of asthma by the age of 12 years in univariate analyses. In multivariate logistic regression, neonatal oxygen supplementation ≥ 9 days was the only remaining significant risk factor for a history of asthma (adjusted OR 6.7, 95%CI 1.0–44). The VLBW children who required mechanical ventilation during the neonatal period were more likely to have bronchial hyperresponsiveness than those not requiring mechanical ventilation (60% vs. 28%, p = 0.050). The spirometric values were similar among the VLBW and the term children at 12 years. Very low birth weight was not significantly related to allergic rhinoconjunctivitis, eczema or positive skin prick tests. Furthermore, the levels of IL-4, IL-5 and IFN-γ in stimulated cell cultures were similar in the VLBW and the term children. A history of asthma by 12 years of age was twice as common among the VLBW as the term children, and neonatal oxygen supplementation seemed to be associated with the increased risk. Furthermore, mechanical ventilation during the neonatal period was associated with bronchial hyperresponsiveness at age 12. Very low birth weight per se was not, however, related to atopy.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26442 (URN)10.1034/j.1399-3038.2003.00045.x (DOI)10985 (Local ID)10985 (Archive number)10985 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
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