RESUMEN
The aim of this study was to determine if preterm birth is associated with socioeconomic status (SES), psychological functioning, and health-related quality of life (HRQoL) in adulthood. We used prospective follow-up of 192 adult offspring of mothers who took part in a randomized controlled trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome (66 born at term [33 males, 33 females] 126 born preterm [66 males, 60 females]). Cognitive functioning was assessed using the Wechsler Abbreviated Scale of Intelligence. Working memory and attention was assessed using the Benton Visual Retention Test, the Paced Auditory Serial Addition Test, and the Brown Attention Deficit Disorder Scale. Psychiatric morbidity was assessed using the Beck Depression Inventory II, the State-Trait Anxiety Inventory, and the Schizotypy Traits Questionnaire. Handedness was assessed using the Edinburgh Handedness Inventory. HRQoL was assessed using the Short Form-36 Health Survey. Moderately preterm birth (median gestation 34wks, mean birthweight 1946g [SD 463g]) was not related to later marital status, educational attainment, SES, cognitive functioning, working memory, attention, or symptoms of anxiety or schizotypy at 31 years of age. Preterm birth was associated with fewer symptoms of depression and higher levels of satisfaction in three of the eight HRQoL domains measured (bodily pain, general health perception, and social functioning). Adults who were born moderately preterm have SES, psychological functioning, and HRQoL consistent with those who were born at term. This good long-term outcome cannot be extrapolated to those with early childhood disability or very low birthweights.
Asunto(s)
Cognición/fisiología , Inteligencia , Nacimiento Prematuro/fisiopatología , Nacimiento Prematuro/psicología , Calidad de Vida , Adolescente , Adulto , Atención/fisiología , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Masculino , Análisis Multivariante , Pruebas Neuropsicológicas , Evaluación de Resultado en la Atención de Salud , Estudios RetrospectivosRESUMEN
OBJECTIVES: To determine if antenatal exposure to betamethasone for the prevention of neonatal respiratory distress syndrome alters psychological functioning and health related quality of life in adulthood. DESIGN: Follow-up of the first and largest double blind, placebo controlled, randomised trial of a single course of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome. SETTING: Tertiary obstetric hospital in Auckland, New Zealand. PARTICIPANTS: 192 adult offspring, mean age 31 years, of mothers who took part in a randomised controlled trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome (87 exposed to betamethasone and 105 exposed to placebo). INTERVENTIONS: Mothers received two doses of betamethasone or placebo 24 hours apart. MAIN OUTCOME MEASURES: Cognitive functioning assessed with Wechsler abbreviated scale of intelligence; working memory and attention assessed with Benton visual retention test, paced auditory serial addition test, and Brown attention deficit disorder scale; psychiatric morbidity assessed with Beck depression inventory II, state-trait anxiety inventory, and schizotypy traits questionnaire; handedness assessed with Edinburgh handedness inventory; health related quality of life assessed with short form 36 health survey. RESULTS: No differences were found between groups exposed to betamethasone and placebo in cognitive functioning, working memory and attention, psychiatric morbidity, handedness, or health related quality of life. CONCLUSIONS: Prenatal exposure to a single course of betamethasone does not alter cognitive functioning, working memory and attention, psychiatric morbidity, handedness, or health related quality of life in adulthood. Obstetricians should continue to use a single course of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome.
Asunto(s)
Betametasona/efectos adversos , Glucocorticoides/efectos adversos , Trastornos Mentales/inducido químicamente , Calidad de Vida , Síndrome de Dificultad Respiratoria del Recién Nacido/prevención & control , Adulto , Atención/efectos de los fármacos , Trastornos del Conocimiento/inducido químicamente , Femenino , Estudios de Seguimiento , Lateralidad Funcional/efectos de los fármacos , Humanos , Recién Nacido , Masculino , Trastornos de la Memoria/inducido químicamente , Embarazo , Efectos Tardíos de la Exposición Prenatal , Pronóstico , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Central administration of N-terminal tripeptide of IGF-1 (GPE) prevents the loss of dopamine neurons. We now examine effects of GPE administered peripherally, on long-term functional recovery after 6-OHDA lesion in rats. GPE treatment (3 mg/kg, i.p.), 3 days after the lesion reduced the number of rotations (p<0.005) and the time over meter (p<0.005) compared to vehicle treatment. Step length and number of adjusting steps were increased in the GPE group (p<0.005), particularly at 12 weeks post lesion. However, GPE treatment did not prevent the loss of tyrosine hydroxylase in the substantia nigra pars compacta and the striatum. The study suggests that peripheral administration of GPE after onset of nigrostriatal dopamine depletion improves long-term Parkinsonian motor deficits, independent of neuronal outcome.
Asunto(s)
Cuerpo Estriado/fisiología , Factor I del Crecimiento Similar a la Insulina/uso terapéutico , Fármacos Neuroprotectores/uso terapéutico , Oligopéptidos/uso terapéutico , Oxidopamina/toxicidad , Enfermedad de Parkinson/tratamiento farmacológico , Sustancia Negra/fisiología , Animales , Conducta Animal/efectos de los fármacos , Recuento de Células/métodos , Cuerpo Estriado/lesiones , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Lateralidad Funcional , Inmunohistoquímica/métodos , Masculino , Actividad Motora/efectos de los fármacos , Enfermedad de Parkinson/fisiopatología , Desempeño Psicomotor/efectos de los fármacos , Ratas , Ratas Wistar , Rotación , Sustancia Negra/lesiones , Simpaticolíticos/toxicidad , Factores de Tiempo , Tirosina 3-Monooxigenasa/metabolismoRESUMEN
The present study compared the short-term and long-term neuroprotective and neurobehavioral effects of transforming growth factor beta-1 (TGF beta-1) after hypoxic-ischemic injury in adult rats. TGF beta-1 (10 ng) or vehicle were administered intracerebroventricularly (i.c.v.) 2 h after hypoxia-ischemia. Adhesive removal test was assessed after 10 or 40 days, and the neuronal outcome then determined. TGF beta-1 significantly increased the area of intact cortex compared with vehicle 10 days after the injury, with a significant improvement in neurological function. In contrast, after 40 days recovery TGFbeta-1 neither improved neuronal outcome nor neurological function, suggesting TGFbeta-1 can transiently improve functional and histological recovery from hypoxia-ischemia.