Preemies Aren't Little Term Babies

Disorders of feeding and swallowing, and the risk of aspiration are increased in premie infants.  This study highlights that a routine surgery performed for a common pediatric disorder known as as laryngomalacia (floppy airway) may significantly raise risk for aspiration more so than in term infants. Dr. Susarla

The effects of prematurity on incidence of aspiration following supraglottoplasty for laryngomalacia.

Abstract

OBJECTIVES:

To determine if patients who were born premature have a higher incidence of aspiration following supraglottoplasty compared to patients born full term.

STUDY DESIGN:

Retrospective study.

METHODS:

Two thousand three hundred sixty (2360) patient charts from Riley Hospital for Children were reviewed retrospectively. Patients had already been treated for laryngomalacia with supraglottoplasty by Dr. Bruce Matt. Estimated weeks gestational age at birth was recorded for each patient. Prematurity was stratified as mild (32-36 weeks gestational age [WGA]), very (28-31 WGA), or extremely (<28 WGA). Patients were excluded from the study if they had suspected aspiration with chronic cough, pneumonia, chronic lung disease, or documented aspiration prior to supraglottoplasty.

RESULTS:

As previously shown, 75 patients (3.2%) had aspiration following supraglottoplasty. Twenty of these patients were preterm infants at birth. The rate for aspiration following supraglottoplasty for former premature infants was statistically significant (5.9%, odds ratio = 2.3, P = .0032).

CONCLUSIONS:

Children who were born premature have a higher rate of postoperative aspiration following supraglottoplasty; however, supraglottoplasty should still be considered as treatment for laryngomalacia as the rate is still relatively low (5.9%).

Abstract linked here.

Study: Preemies are at a higher risk of asthma

A study shows that babies born prematurely are more likely to develop asthma, although the reason why this is so is not completely understood.

The World Health Organization estimates that 15 million babies are born premature every year, which means they are born before 37 weeks. But new research suggests that risks are higher than previously thought for preterm babies to develop childhood asthma, compared with their full-term counterparts.

Publishing their results in the journal PLoS Medicine, the researchers studied data on more than 1.5 million children around the world.

They used information on patients born since the 1990s from 30 studies, which came from six continents. The majority of the studies came from Europe.

Preterm babies often encounter breathing problems because their lungs are immature, the authors note. They drew from previous research on preterm children born between the 1960s and 1980s, which showed that many of them developed asthma.

However, the researchers say it was unclear whether improved care for preterm babies since then has affected the long-term risk of developing asthma.

Asthma is the most common chronic disease in children, and the team notes that because an increasing number of preterm babies survive birth, the condition is becoming a "significant health problem."

Preterm babies 50% more likely to develop asthma

Overall, the study revealed that while asthma affects 8% of children born at full term, it affects 14% of preterm babies.

In detail, the team found that babies born before 37 weeks were 50% more likely to develop asthma, and those born 2 months early were three times as likely to develop asthma, compared with full-term babies.

Additionally, risks of developing the breathing condition were the same for preschoolers and school-age children, which suggests children who are born early do not outgrow the risk.

"Doctors and parents need to be aware of the increased risks of asthma in premature babies, in order to make early diagnosis and intervention possible," says Dr. Jasper Been, lead study author from the University of Edinburgh's Centre for Population Health Sciences in Scotland.

Dr. Been adds:

"By changing the way we monitor and treat children born preterm, we hope to decrease the future risks of serious breathing problems, including asthma. Our findings should help find better ways to prevent and treat asthma and asthma-like symptoms in those born preterm."

Standard asthma meds 'safe in pregnancy'

The authors say the results of their study provide "compelling evidence" that preterm birth increases asthma risks, and they note that future research "needs to focus on understanding underlying mechanisms, and then to translate these insights into the development of preventive interventions."

But Dr. Samantha Walker, executive director of research and policy at Asthma UK, emphasizes the importance of current asthma medications:

"Standard asthma medicine is very safe to use in pregnancy, and by far the most important way to reduce this risk is for pregnant women to take their medication as prescribed."

She adds that maintaining a healthy weight, staying active, avoiding stress and not smoking are also important measures to keep in mind.

When asked about any further research the team has planned, Dr. Been told Medical News Today:

"An important factor that causes both preterm birth and asthma, particularly in those born preterm, is tobacco smoke exposure before birth. Our current research focuses on evaluating interventions to address this issue."

In other asthma news, a study recently suggested that secondhand smoke is linked to hospital readmission for asthmatic children. The authors of that study believe their findings could prompt insurance companies to give incentives to parents or guardians who quit smoking.

Read more here

Turmeric Component Can Prevent Lung Damage in Premature Babies

Perhaps another nod to medicine through better nutrition, curcumin is a known potent antioxidant found in turmeric.  Oxidative injury is thought toplay a major role in bronchopulmonary dysplasia, a chronic lung condition affecting premature infants. Dr Susarla

Turmeric Component Can Prevent Lung Damage in Premature Babies

• A component found in turmeric can prevent lung damage in premature babies, a new study says.
  Babies born before 37 weeks of gestational age are considered to be premature babies. Though most of the internal systems of an unborn baby develop by 32 weeks, according to health experts, lungs remain immature at eight month of pregnancy and take more time to fully develop.
  So when babies are born before completing their gestational age, their lungs are not  fully developed. They require ventilation support and oxygen therapy. However, the therapies have long been found to increase the risk of lung damage, a condition known as bronchopulmonary dysplasia (BPD).  The condition is often accompanied by fluid in lungs and scarring. According to the American Lung Association, between 5,000 and 10,000 babies are affected with BPD every year. 
  The study reported in the American Journal of Physiology, Lung Cellular and Molecular Physiology, found a component in turmeric, known as curcumin, effective in protecting babies against the risk of the lung damage (BPD) and hyperoxia- a condition that is caused by excess oxygen in the body.  Premature babies often suffer from this condition nearly 21 days after birth.  
  The findings are based on the experiments conducted by a team of researchers from Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed), with the help of disease models.
  "This is the first study to find long-term benefits of using curcumin to protect lung function in premature infants," Virender K. Rehan, author of the study, said in a news release. "Curcumin is known to have potent antioxidant, anti-inflammatory and anti-microbial properties, making it a promising therapy for premature infants who require oxygen therapy after birth."
  Preterm birth is the leading cause of newborn deaths and the second leading cause of death among children aged below 5 in the world. In the U.S. more than half a million babies are born prematurely. Apart from BPD, premature babies are affected by a series of health problems, including apnea; respiratory distress syndrome; jaundice; anemia; problems related to intestines (Necrotizing enterocolitis -NEC) and infections, particularly to lungs, blood, brain and spinal cord.
  Read article here.