Born just a few weeks early… is this relevant? : Insights into brain lesions, brain growth, and outcome in moderate-late preterm infants
Notice bibliographique
Résumé
This thesis gives insights into neonatal brain injury, brain growth and neurodevelopmental outcome in moderate-late preterm (MLPT) infants, born at 32–36 weeks’ gestation. Additionally, we describe the neurodevelopmental outcome of preterm infants with cerebellar hemorrhage (CBH). In Chapter 2 we give an overview of the literature regarding brain injury and development in MLPT infants. Most frequently studied types of brain injury were intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL). Incidences of other forms of brain injury were sparsely reported. In addition, there is a lack of knowledge regarding the effect of brain injury on neurodevelopmental outcome in MLPT infants. In Chapter 3, we investigate current practice regarding neurological surveillance in MLPT infants in the Netherlands and Canada. We found variations in local practices regarding e.g. admission criteria, neuroimaging and follow-up. This may partially be explained by the lack of guidelines regarding care of MLPT infants. The above indicates that considerable knowledge about MLPT infants is still lacking. By conducting a prospective cohort study, we sought to fill some of the gaps in knowledge. The BIMP-study (Brain Imaging in Moderate-late Preterm infants) was performed between 2017-2019 at the Isala Women and children’s Center in Zwolle, the Netherlands. MLPT infants underwent cranial ultrasound and MRI. In the BIMP-cohort (n= 166), a high incidence of mild brain lesions (71.7%) was found. Frequent findings were signs suggestive of white matter injury, and small hemorrhages, including CBH. Moderate-severe brain lesions were seen in 3.6% of infants. We compared linear measurements of brain structures between MLPT and full-term infants. Biparietal diameter and basal ganglia width were smaller in MLPT infants. We found no differences in linear measurements or in brain volumes between moderate preterm (MP, 32+0–33+6 weeks) and late preterm infants (LP, 34+0–35+6 weeks). Mild brain lesions had no effect on brain volumes (Chapters 4, 5 and 6). In Chapter 7, we present a preliminary overview of the follow-up of 85 MLPT infants who have now reached 24 months of age. Almost one in three (30.6%) had an suboptimal outcome score. Given the descriptive nature of this overview and the fact that follow-up is still ongoing, we could not yet draw any further conclusions. In Chapter 8, we explore the association between the size and location of CBH in preterm infants ≤34 weeks (n = 218) and neurological outcome around two years of age. All infants with massive CBH and involvement of the vermis on neonatal MRI had a less favorable outcome. Infants with limited CBH had a more favorable outcome than infants with massive CBH. Although much research is still needed to provide strict recommendations, we advise the following based on our findings and the current literature: - Standard neuroimaging in MLPT infants does not seem warranted at present. - Use a low threshold for accepting MLPT infants in neurodevelopmental follow-up programs and interventions as they are at risk of neurodevelopmental and behavioral problems. - Assess CBH based on size and location. With a special note on vermian involvement.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».