Prématurité et interventions

Publication scientifique

Nés trop vite et trop petits:

Étude sur les bébés de faible poids au Canada

Publiée par l'Institut canadien d'information sur la santé

Les nouveau-nés prématurés (moins de 37 semaines de gestation) ou petits par rapport à l'âge gestationnel courent un risque plus élevé de morbidité et de mortalité. Le rapport examine le lien entre certains facteurs de risque et les nouveau-nés prématurés ou petits par rapport à l'âge gestationnel à l'échelle des provinces et territoires (à l'exception du Québec) en utilisant les données de 2006-2007 de la Base de données sur les congés des patients (BDCP) de l'ICIS. Le document comprend également de l'information sur les coûts hospitaliers liés aux naissances prématurées, aux nouveau-nés petits par rapport à l'âge gestationnel et aux nouveau-nés de poids insuffisant.
L'étude est disponible en ligne.

Positive Screening for Autism in Ex-preterm Infants: Prevalence and Risk Factors

PEDIATRICS  vol. 121, No. 4, April 2008, pp. 758-765.
Catherine Limperopoulos PhD, Haim Bassan MD, Nancy R. Sullivan PhD, Janet S. Soul MD, Richard L. Robertson MD, Marianne Moore BA, RN, Steven A. Ringer MD, PhD, Joseph J. Volpe MD and André J. du Plessis MBChB, MPH.

Objective
The survival of very low birth weight infants has increased markedly in recent years. Unfortunately, the prevalence of significant and lifelong motor, cognitive, and behavioral dysfunction has remained a major problem confronting these children. The objective of this syudy was to perform screening tests for early autistic features in children with a history of very low birth weight and to identify risk factors associated with a positive screening result.

Methods
We studied 91 ex-preterm infants <1500g at birth. Infants underwent conventional MRI studies at preterm and/or term-adjusted age. We collected pertinent demographic, prenatal, intrapartum, acute postnatal, and short-term outcome data for all infants. Follow-up assessments were performed at a mean age of 21.9 ± 4.7 months, using the Modified Checklist for Autism in Toddlers, the Vineland Adaptive Behavior Scale, and the Child Behavior Checklist.

Results
Twenty-six percent of ex-preterm infants had a positive result on the autism screening tool. Abnormal scores correlated highly with internalizing behavioral problems on the Child Behavior Checklist and socialization and communication deficits on the Vineland Scales. Lower birth weight, gestational age, male gender, chorioamnionitis, acute intrapartum hemorrhage, illness severity on admission, and abnormal MRI studies were significantly associated with an abnormal autism screening score.

Conclusion
Early autistic behaviors seem to be an underrecognized feature of very low birth weight infants. The results from this study suggest that early screening for signs of autism may be warranted in this high-risk population followed by definitive autism testing in those with positive screening results.