A maternal age of 35 years and over may increase the risk for cystic periventricular leukomalacia in very preterm infants

BACKGROUND

Some studies have shown increased risk for neonatal morbidity and mortality with increasing maternal age. The aim of this study was to assess the influence of a maternal age of 35 years, and older, on the neonatal morbidities and mortality of very preterm infants.

METHODS

Obstetrical and neonatal data on mothers and preterm infants with gestational age 24 to 30 weeks, born during 2015 and 2016 after a surveilled pregnancy at 11 Portuguese level III centers were analyzed according to a mother's age <35 years versus ≥35. Statistical analysis was performed using IBM SPSS statistics 23 (IBM, Armonk, NY, USA) and a P value <0.05 was considered significant.

RESULTS

A total of 415 mothers and 499 infants were included; 340 (68.1%) infants were delivered to mothers <35 years old and 159 (31.9%) to mothers ≥35. There were no differences in birthweight, gestational age and gender in both groups of preterm infants. Rupture of membranes over 18 hours and chronic hypertension with superimposed preeclampsia were significantly more frequent in mothers ≥35 years. Cystic periventricular leukomalacia (cPVL) assessed by cranial ultrasound was significantly more prevalent in infants delivered to mothers ≥35 years. The multivariate analysis by logistic regression revealed an association between cPVL and a maternal age ≥35 years (OR=2.34, 95% CI: 1.20-4.54; P=0.012).

CONCLUSIONS

Our study revealed a significant association between a maternal age ≥35 years and echographic cPVL in preterm infants below 30 weeks of gestational age.

Hypertensive Disorders during Pregnancy and Risk of Bronchopulmonary Dysplasia in Very Preterm Infants

INTRODUCTION

It is not yet fully known whether hypertensive disorders (HTD) during pregnancy impose an increased risk of development of bronchopulmonary dysplasia (BPD) in preterm newborn infants.

OBJECTIVE

To test the hypothesis that preeclampsia and other HTD are associated with the development of BPD in preterm infants.

MATERIALS AND METHODS

Data on mothers and preterm infants with gestational age 24 to 30 weeks were prospectively analyzed in 11 Portuguese level III centers. Statistical analysis was performed using IBM SPSS statistics 23.

RESULTS

A total of 494 preterm infants from 410 mothers were enrolled, and 119 (28%) of the 425 babies, still alive at 36 weeks, developed BPD. The association between chronic arterial hypertension, chronic arterial hypertension with superimposed preeclampsia, and gestational hypertension in mothers and BPD in preterm infants was not significant (p = 0.115; p = 0.248; p = 0.060, respectively). The association between preeclampsia-eclampsia and BPD was significant (p = 0.007). The multivariate analysis revealed an association between preeclampsia-eclampsia and BPD (odds ratio [OR] = 4.6; 95% confidence interval [CI] 1.529-13.819; p = 0.007) and a protective effect for BPD when preeclampsia occurred superimposed on chronic arterial hypertension in mothers (OR = 0.077; 95%CI 0.009-0.632; p = 0.017).

CONCLUSION

The results of this study support the association of preeclampsia in mothers with BPD in preterm babies and suggest that chronic hypertension may be protective for preterm babies.

Correction: Preeclampsia predicts higher incidence of bronchopulmonary dysplasia

Text for Correction.

Translation and cross-cultural adaptation of the Pediatric Sleep Questionnaire into Portuguese language

OBJECTIVE

The need for culturally appropriate and linguistically accessible instruments for assessing sleep quality among children has expanded. The Pediatric Sleep Questionnaire (PSQ) is a validated tool for sleep disordered breathing among children. Our aim was to cross-culturally translate and adapt the PSQ into Portuguese language for use in clinical and research settings.

METHODS

The PSQ was translated into Portuguese language in accordance with the stages recommended by International Guidelines and reviewed by a panel of experts. The caregivers of 180 children (aged from 4 to 12 years) answered the Portuguese version of PSQ. The reliability of the translated questionnaire was measured by Cronbach α, Pearson correlation and Kappa statistics.

RESULTS

Reliability analysis yielded an overall Cronbach α of 0.781, confirming the survey's consistency. The Cronbach α of the Portuguese PSQ domains ranged between 0.61 and 0.7. Test-retest reliability for all items was robust with correctness of >90.0% in all items, and the Kappa statistic ranged between 0.5 and 0.8.

CONCLUSION

The Portuguese version of PSQ has sufficient reliability and validity to measure sleep disordered breathing outcomes, and showed to be linguistically accurate and acceptable for use by children in Portugal.