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Background: It has been suggested that the atypical language development of very preterm (VPT) children is related to an altered, more bilateral language organization. The corpus callosum (CC), in particular the splenium, is considered important for the lateralization process and is also associated with auditory processing.

Objective: Exploring whether decreased binaural auditory integration skills in school-aged VPT children are associated with language problems and decreased interhemispheric connectivity.

Methods: Cross-sectional case-control study of 63 VPT children and 30 full term (FT) controls at 10 years of age. Language performance (using Clinical Evaluation of Language Fundamentals-4) and binaural integration skills (using dichotic digit test, DDT) were assessed. In 44 VPT children, additionally, diffusion weighted MRI was performed on a 3 Tesla scanner. Fractional anisotropy (FA) and mean diffusivity (MD) values of the genu, body and splenium of the CC were extracted. Linear regression models were used to (1) relate DDT scores to birth group, (2) associate language scores to DDT scores and (3) associate DDT scores to DWI indices.

Results: VPT birth was associated with poorer DDT scores. Poorer DDT scores were associated with poorer language performance in VPT, but not in FT children. MD, but not FA, of the splenium was significantly associated with DDT performance.

Conclusion: This study supports the hypothesis that poor language performance in VPT children, but not that in FT children, might be a consequence of bilateral language organization, due to poorer developed splenium of the CC.

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Background: Babies born to smokers weigh on average 200g less than those born to non-smokers and are at 40% higher risk of being born preterm. The relative risk of admission to Neonatal Intensive Care units (NICU) for infants of smokers is increased by at least 20%. NICU admission may represent a ‘teachable moment’ where parents are receptive to smoking cessation.

Methods: Qualitative interviews seeking feedback on potential intervention approaches were conducted with parents and family members of babies admitted to NICUs. Participants were purposively sampled (n=40) from NICUs across two large UK teaching hospitals, seeking maximum variation in key demographics. Data were collected by neonatal research nurses. All data were audio recorded and transcribed verbatim before inductive thematic analysis.

Results: Parents are amenable to smoking cessation. Sensitive, timely support is needed for those willing to quit, and those who have quit but are at high risk of relapse. Support might best be delivered by a NICU nurse with specialist training. Support with cessation and relapse prevention through information about smoke-free homes, nicotine replacement therapy and/or support to use nicotine in significantly less harmful ways (e.g. vaping) were identified as promising routes for intervention. Parents welcomed ongoing digital support following discharge from NICU.

Conclusions: There is presently little dedicated support for smoking cessation, relapse prevention or smoke-free homes for families of NICU babies. Parents are amenable to support and consider a focus on smoke-free homes as a less stigmatising way in which smoking cessation may be promoted to improve neonatal health.

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Aim: The aim of the study was to assess the long-term effects of premature birth on ocular parameters in infants with ROP of different severity.

Method: 71 children (age 8-10 years): 33 born between 28-32 weeks of gestational age (12 with diagnosis of type1 ROP (G_PT1) and 21 with type2 ROP (G_PT2)) and a control group of 38 children born full-term (CG) were examined. Refractive state, ultrasound, anterior eye, eye alignment and visual performance were assessed.

Results: In the G_PT1 there was asignificantly higher prevalence of myopia (58% vs 15%) and astigmatism (71% vs 14%) when compared to CG (p<0.001). In G_PT2there was a higher prevalence of moderate or high hyperopia (>2D)than in CG (38% vs 12%; p<0.05). Significantly smaller axial eye ball length was observed in G_PT1 and G_PT2 than CG(22.0 vs 22.2 vs 23.1 mm, p<0.001). The corneal eccentricity was higher in G_PT1 and G_PT2 than CG (0.63 vs 0.56, p<0.001). The prevalence of strabismus in the G_PT1 was very high (92% of cases),lower in G_PT2(24% of cases) and the lowest in CG (3%. p<0.05). Both preterm groups indicated lower than CG visual acuity (0.40 vs 0.02 vs -0.08 logMAR, p<0.026) and poorer ocular motility (NSUCO test: 13 vs 16 vs 20 points, p<0.001).

Conclusions: Premature birth increases the incidence of ocular abnormalities at school age regardless of the stage of ROP. Significant ocular disorders occur also in type 1 ROP patients which should be considered in planning the follow-up care.

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Introduction

Adults Born Very Preterm (ABP) are an underperceived but steadily increasing patient population.

Very little is known about their specific health care needs beyond childhood and adolescence.

This qualitative study focuses on their personal perspectives and points to health care-related barriers they face.

Methods:

We conducted 20 individual in-depth interviews with adults born preterm aged 20 to 54

years with a gestational age at birth < 33 weeks of gestation and birth weights ranging

from 870 g to 1950 g. Qualitative content analysis of the narrative interview data was

conducted to identify themes related to self-perceived health, health care satisfaction

and social well-being.

Results:

The majority (85%) of the study participants reported that their former prematurity is

still of concern in their everyday lives as adults. The prevalence of self-reported

physical (65%) and mental (45%) long-term sequelae of prematurity was high. Most

participants expressed dissatisfaction with health care services regarding their former

prematurity. Lack of consideration for their prematurity status by adult health care

providers and the invisibility of the often subtle impairments they face were named as

main barriers to receiving adequate health care. Age and burden of disease were

important factors influencing participants’ perception of their own health and health

care satisfaction.

Discussion:

Adults born preterm are a patient population underperceived by the health care

system. Longterm effects of very preterm birth should

encourage our effort to provide adequate follow-up and prevention programs

specifically designed for this population.