PubMed Health⌕ Search

Biomedical subjects

S Saigal

Publications and source records attributed to S Saigal.

13 recordsLinked to original sources
PubMed1992

Non-right handedness among ELBW and term children at eight years in relation to cognitive function and school performance.

The relationship between handedness, neurological and cognitive deficits, and school difficulties was investigated in 114 extremely low-birthweight (ELBW) children and 145 term controls at eight years. The prevalence of non-right handedness (left and mixed) was 31 per cent for ELBW children and 19 per cent for controls. ELBW children with neurological impairments were significantly more likely to be non-right handed. No significant differences were noted between right-handed and non-right handed ELBW children and controls on tests of cognitive function, school performance and prevalence of learning difficulties. These findings suggest an association between neurological impairment and non-right handedness, but do not support the hypothesis of early brain insult resulting in subtle cognitive deficits and suboptimal school performance among non-right handed ELBW children.

Achievement↗
PubMed1992

Can learning disabilities in children who were extremely low birth weight be identified at school entry?

This prospective study was designed to test the hypothesis that a significant proportion of extremely low birth weight (ELBW) children identified as "at risk" for school problems at age 5 years by the Florida Kindergarten Screening Battery (FKSB) will present with specific learning disability (LD) when retested at age 8 years. A regional cohort of 81 of 84 ELBW survivors born between 1980 and 1982 were reassessed at age 8 years by Wechsler Intelligence Scale for Children-Revised (WISC-R), Wide Range Achievement Test-Revised (WRAT-R), and tests of motor function. The association of FKSB risk status and WRAT-R reading subtest for predicting general reading disability in the overall sample at age 8 years resulted in a sensitivity of 0.68, specificity of 0.48, and a likelihood ratio of 1.3. Of the 43 "normal" children at age 5 years with no neurosensory impairments and IQ > or = 84 (McCarthy GCI), 49% were considered to be at "mild" to "high" risk for future LD. The prevalence of specific LD (reading disorder) at age 8 years in children with normal IQ (WISC-R > or = 85) was 28%. The positive predictive value of the 5-year FKSB for identifying children with specific LD at age 8 years was 0.20 (sensitivity 0.33, specificity 0.48). We conclude the FKSB is not an efficient tool for predicting either general or specific LD in ELBW children.

Achievement↗
PubMed1991

Cognitive abilities and school performance of extremely low birth weight children and matched term control children at age 8 years: a regional study.

The intellectual, psychoeducational, and functional status of a regional cohort of extremely low birth weight (ELBW) survivors who weighed 501 to 1000 gm at birth (n = 143) and who were born between 1977 and 1981 was compared with that of control children born at term (n = 145) who were matched for gender, age, and social class. One hundred twenty-nine ELBW survivors (90%) were available; their mean birth weight was 839 +/- 124 gm and mean gestational age 27 +/- 2.1 weeks, and 48 of them weighed less than or equal to 800 gm at birth. Both ELBW and control groups were tested at a mean unadjusted age of 8 years; 113 of 129 ELBW children completed the full test battery, eight blind children had other tests, and eight were not testable. The mean Full Scale IQ (Wechsler Intelligence Scale for Children--Revised) was 91 +/- 16 for ELBW children and 104 +/- 12 for control children (p less than 0.0001). Between 8% and 12% of the ELBW group scored in the "abnormal" range (less than or equal to -2 SD) on the Wechsler IQ and subtests, compared with 1% to 2% of the control group. The ELBW group did less well on the reading, spelling, and mathematics tests (Wide Range Achievement Test--Revised less than or equal to -2 SD: ELBW = 20% to 28%; control = 3% to 10%). The motor performance of the ELBW group (Bruininks-Oseretsky Test of Motor Proficiency less than or equal to -2 SD: ELBW = 20%; control = 1%) and their visual-motor integration (Beery Developmental Test of Visual-Motor Integration less than or equal to -2 SD: ELBW = 21%; control = 6%) were also poorer. Exclusion of 19 ELBW children with neurologic impairments or an IQ less than or equal to 70 or both did not result in significant improvement in Wechsler or achievement measures. Approximately 15% of the ELBW cohort performed in the abnormal range on the Vineland Adaptive Behavior Scales, compared with none of the control group. Although approximately two thirds of the ELBW group were performing in the normal range on intellectual measures, comparison with the control group suggests that, as a group, ELBW children were significantly disadvantaged on every measure tested.

Achievement↗
PubMed1991

Learning disabilities and school problems in a regional cohort of extremely low birth weight (less than 1000 G) children: a comparison with term controls.

We compared the prevalence of learning disabilities at age 8 years in a subgroup of 68 of 129 (53%) regional cohort of extremely low birth weight (ELBW) children who were considered "normal" neurologically and intellectually (IQ greater than or equal to 85) with that of 114 term group matched controls (C). Both groups were tested with a battery of psychoeducational measures, and parents and teachers completed questionnaires on the school performance of the children. ELBW children were comparable with C on measures of intelligence (ELBW 101 +/- 8, C 104 +/- 11), language, and academic achievement but fared significantly less well in motor performance (p less than .0001). The prevalence of learning disabilities (by predefined criteria) in ELBW children (26%) was not increased compared with C (19%). However, teachers rated significantly more ELBW children as performing below grade level than were C (31% vs 16%, p less than .05), and by parent report, a higher proportion of ELBW children had received special assistance in school compared with C (37% vs 16%, p less than .001). We conclude that although the prevalence of learning disabilities in normal ELBW children was not different from that in controls, ELBW children did less well and utilized more special resources.

Achievement↗
PubMed1990

Intellectual and functional status at school entry of children who weighed 1000 grams or less at birth: a regional perspective of births in the 1980s.

The intellectual and functional status of a regional cohort of children who weighed 501 to 1000 gm when born between 1980 and 1982 was evaluated at a mean age of 5 1/2 years by standard psychometric tests. Of 90 long-term survivors (survival rate 49%), 78 children (87%) had the full test battery, 5 children (6%) had other tests (4 were blind), and one child was untestable. Most of the mean scores were within 1 SD of the test norms; the lowest scores were in the McCarthy Motor scale and in the Beery Test of Visual-Motor Integration. Children without neurologic impairments and those with an IQ greater than or equal to 68 (n = 60) had higher overall scores but still performed poorly on the Motor subscale and the Beery test. Children who weighed less than 800 gm at birth (n = 28) were similar to those who weighed greater than 800 gm (n = 50), except in the Memory and Motor subscales, in which they performed significantly less well. At a functional level, determined by the Vineland Adaptive Behaviour Scales, two thirds of the children were performing in the adequate range and the remainder in the moderately low to low range. Of the 43 children with no neurosensory impairments and an IQ greater than or equal to 84, 49% were identified (by the Florida Kindergarten Screening Battery) to be at mild to high risk for future learning disabilities. The data from this unselected population provide an unbiased estimate of the prevalence of intellectual and functional problems in children who weighed less than or equal to 1000 gm at birth.

Anthropometry↗
PubMed1990

Psychiatric disorders at five years among children with birthweights less than 1000g: a regional perspective.

The relationship between extremely low birthweight (ELBW) and psychiatric disorder was investigated in a cohort of children of 500 to 1000g birthweight, born between 1980 and 1982. At five years of age data were collected for 82 of 90 survivors on psychiatric symptoms, parent-reported developmental delay and various aspects of psychosocial disadvantage. Compared with controls, ELBW children did not come from more disadvantaged environments, but were much more likely to experience developmental delay and problems with motor co-ordination. 16 per cent had an attention deficit disorder with hyperactivity (ADDH), compared with 6.9 per cent of controls. Rates of conduct disorder and emotional disorder were not raised, indicating that ELBW is a specific risk factor for ADDH. Controlling for the effect of neurodevelopmental problems rendered the association between ELBW and ADDH non-significant.

Attention Deficit Disorder with Hyperactivity↗
PubMed1989

Decreased disability rate among 3-year-old survivors weighing 501 to 1000 grams at birth and born to residents of a geographically defined region from 1981 to 1984 compared with 1977 to 1980.

In this article we report the survival and morbidity rates for all live-born infants weighing 501 to 1000 gram at birth and born to residents of a defined geographic region from 1977 to 1980 (n = 255) compared with 1981 to 1984 (n = 266). During these periods, there were no changes in the proportion of infants delivered at the tertiary care center or community hospitals (171/84 vs 194/72); use of the tertiary care center increased only slightly, from 84% to 91%; and changes in neonatal management were mainly in improvements in diagnostic and monitoring techniques. When infants were grouped according to birth weights in 100 gm increments, survival improved significantly only for infants weighing between 501 and 600 gm at birth (2% vs 20% p less than 0.001). There were no differences in the overall survival rates to hospital discharge (46% vs 48%). The prevalence of neurosensory impairments was 24% in period 1 and 17% in period 2. There was a significant improvement in the proportion of infants considered to have disabilities by a functional classification assigned at 3 years corrected age (50% vs 27%, p less than 0.001), but only for infants weighing more than 800 gm at birth (49% vs 22%, p less than 0.001). Infants delivered at the community hospitals had a higher prevalence of neurosensory impairments compared with infants delivered at the tertiary care center (period 1, 35% vs 21%, not significant; period 2, 37% vs 14%, p less than 0.05). These data are encouraging; further efforts should be directed toward assessing which, if any, components of perinatal care are contributing to the improvement in morbidity rates.

Academic Medical Centers↗
PubMed1987

Long-term outcome of preterm infants with respiratory disease.

Improved survival of preterm ventilated infants has resulted in an increase in the incidence of bronchopulmonary dysplasia, particularly in very tiny infants. In this article, the authors have reviewed the current literature on the pulmonary function and long-term neurodevelopmental outcome of VLBW infants to determine the true morbidity of respiratory disease in the neonatal period.

Bronchopulmonary Dysplasia↗
PubMed1977

Urine solute excretion in growing low-birth-weight infants.

Fifteen thriving low-birth-weight infants who weighed less than 1,950 gm at birth were randomly selected to study the urine solute excretion on two milk-based proprietary formulas, SMA or Formula 4. The results showed that urine oxmolality rose progressively with increasing caloric concentration and was 78, 111, and 163 mOsm/kg H2O on 67, 80, and 100 kCal/dl SMA, respectively. Formula 4 gave rise to significantly higher urine osmolality (133 mOsm/kg H2O) than SMA, when fed at the same caloric density of 67 kCal/dl. Although the dependence of urine solute excretion on dietary load was confirmed, the rapidly growing low-birth-weight infant appears to incorporate a larger portion of potential urine solute into growing tissues, than is the case in the term infant.

Animals↗
PubMed1977

Radiological findings in symptomatic neonatal plethora resulting from placental transfusion.

As a result of excessive placental transfusion at birth, 8 premature and 3 full-term infants presented with cardiorespiratory and neurological symptoms. Cord clamping was delayed in all infants, and blood volume studies showed polycythemia or hypervolemia. The radiological findings included pulmonary vascular congestion, hyperaeration, pleural effusion, and mild cardiomegaly. Most infants responded to conservative medical management and were asymptomatic within 24 to 72 hours. Three acutely ill infants showed great improvement after phlebotomy, providing further evidence that circulatory overload due to placental transfusion may be the etiological factor in this symptom-complex.

Heart Failure↗
PubMed1977

Symptomatic neonatal plethora.

Blood volume and clinical data are reported on 8 premature and 3 full-term infants who presented with symptoms apparently due to polycythemia or hypervolemia. These cases termed 'symptomatic neonatal plethora' were caused by large placental transfusions associated with delayed clamping of the umbilical cord. Tachypnea, mild cyanosis, plethoric skin color, and neurological depression persisted on average for 30 h after birth. Chest X-rays showed mild cardiomegaly, pulmonary congestion and edema, and pleural effusions. Although the course was in general benign, phlebotomy was considered to be indicated in three infants to treat progressive clinical deterioration. The symptomatology and blood volume on these infants were compared with infants in an ongoing study with controlled time of cord clamping. Neonatal plethora must be considered as one cause of 'transient tachypnea of the newborn'.

Blood Pressure↗
PubMed1975

Estimation of red blood cell volume in premature infants with and without respiratory distress syndrome.

Red blood cell volume was estimated indirectly from plasma volume and venous hematocrit measurements in 262 consecutively delivered premature infants of less than 37 weeks' gestation. Infants with respiratory distress syndrome averaged lower red cell volumes (P0.02) than those without. Fatal cases had the lowest volumes. There was a 10.3% mortality from RDS (respiratory distress syndrome) among the one third of infants with the smallest red cell volumes, and only a 2.3% mortality among the one third with the largest volumes. Red cell volume was shown to be a direct correlate of time of cord clamping and thereby of the amount of placental transfusion, both in infants with and without RDS. From this study it is probable that delayed cord clamping, by allowing placental transfusion, decreases the risk of death from RDS in premature infants. Delay in clamping the umbilical cord for 1-1.5 min is advised in premature births.

Blood Volume↗