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Kaul, Ylva Fredriksson
Publications (5 of 5) Show all publications
Hreinsdottir, J., Kaul, Y. F., Hellström-Westas, L., Rosander, K., von Hofsten, C. & Holmström, G. (2018). Impaired cognitive ability at 2.5 years predicts later visual and ophthalmological problems in children born very preterm. Acta Paediatrica, 107(5), 822-830
Open this publication in new window or tab >>Impaired cognitive ability at 2.5 years predicts later visual and ophthalmological problems in children born very preterm
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2018 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 5, p. 822-830Article in journal (Refereed) Published
Abstract [en]

Aim: To identify possible predictive factors for visual problems at 6.5 years in children born very preterm.

Methods: During 2004–2007, all very preterm infants (gestational age [GA] <32 weeks) in Uppsala County, Sweden were screened for retinopathy of prematurity (ROP) neonatally; at four months, visual tracking was tested; at 2.5 years, visuospatial and cognitive tests were carried out. At 6.5 years, 84 preterm children and a reference group of 64 full‐term children underwent ophthalmological testing.

Results: Mean visual acuity (VA) did not differ between the groups, but subnormal VA (≤0.8) was more common in the preterm group (31% vs 14%; p < 0.05). More often than full‐term children, preterm children had impaired contrast sensitivity (<0.5) (36% vs 19%; p < 0.05) and strabismus (8% vs 0%; p < 0.05). Low GA, ROP, intraventricular haemorrhage 3‐4/periventricular leukomalacia and cognitive disability at 2.5 years predicted ophthalmological and visual problems at 6.5 years. Visual tracking ability at four months was not predictive of ophthalmological outcome.

Conclusion: Children born preterm had more ophthalmological problems at 6.5 years of age, including subtle dysfunctions. ROP, early brain injury and impaired cognitive function around 2.5 years predicted later ophthalmological dysfunctions.

Keywords
Cognition, Long term, Risk factor, Very preterm, Visual outcome
National Category
Ophthalmology Pediatrics
Identifiers
urn:nbn:se:uu:diva-348648 (URN)10.1111/apa.14209 (DOI)000430115100016 ()29288532 (PubMedID)
Available from: 2018-04-16 Created: 2018-04-16 Last updated: 2018-06-19Bibliographically approved
Bolk, J., Kaul, Y. F., Hellström-Westas, L., Stjernqvist, K., Padilla, N., Serenius, F., . . . Åden, U. (2018). National population-based cohort study found that visual-motor integration was commonly affected in extremely preterm born children at six-and-a-half years. Acta Paediatrica, 107(5), 831-837
Open this publication in new window or tab >>National population-based cohort study found that visual-motor integration was commonly affected in extremely preterm born children at six-and-a-half years
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2018 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 5, p. 831-837Article in journal (Refereed) Published
Abstract [en]

Aim: This study aimed to explain the relationship between visual‐motor integration (VMI) abilities and extremely preterm (EPT) birth, by exploring the influence of perinatal variables, cognition, manual dexterity and ophthalmological outcomes.

Methods: This was part of the population‐based national Extremely Preterm Infant Study in Sweden (EXPRESS) study. We studied 355 children, born at a gestational age of <27 weeks from April 2004 to March 2007, and 364 term‐born controls. At six‐and‐a‐half years of age, we assessed VMI, cognitive function, motor skills and vision. VMI impairment was classified as <−1 standard deviation (SD).

Results: The mean (SD) VMI score was 87 (±12) in preterm children compared to 98 (±11) in controls (p < 0.001). VMI impairment was present in 55% of preterm infants and in 78% of children born at 22–23 weeks. Male sex and postnatal steroids showed a weak association with poorer visual‐motor performance, whereas low manual dexterity and cognitive function showed a stronger association.

Conclusion: Poor VMI performance was common in this EXPRESS cohort of children born EPT. Its strong association to cognition and manual dexterity confirms that all of these factors need to be taken into account when evaluating risks in preterm born children.

Keywords
Children, Extremely preterm, Outcome, Perinatal risk factors, Visual-motor integration
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-353367 (URN)10.1111/apa.14231 (DOI)000430115100017 ()29356073 (PubMedID)
Funder
Swedish Research Council, 523-2011-3981Stockholm County Council, ALF-20160227Marianne and Marcus Wallenberg Foundation, 2011.0085The Swedish Medical AssociationThe Swedish Brain Foundation
Available from: 2018-06-19 Created: 2018-06-19 Last updated: 2018-06-19Bibliographically approved
Naseh, N., Gonzalez, K. E., Vaz, T., Ferreira, H., Kaul, Y. F., Johansson, M., . . . Hellström-Westas, L. (2017). Early Hyperglycemia And Brain MRI Findings In Very Preterm Infants. Acta Paediatrica, 106(SI 469), 16-16
Open this publication in new window or tab >>Early Hyperglycemia And Brain MRI Findings In Very Preterm Infants
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2017 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no SI 469, p. 16-16Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Objective: A previous study in extremely preterm infants demonstrated an association between hyperglycemia >8.3 mmol/l (150 mg/dl) on the first day of life and white matter reduction. The objectives of the present study were to further investigate possible associations between hyperglycemia and abnormal brain development and to evaluate the effect of hyperglycemia on neurodevelopment.

Method: Retrospective study of cerebral MRIs performed at term equivalent age in 75 very preterm infants (GA 22–31 weeks) born 2011–2015. The highest glucose values for each day, and the number of days with glucose >8.3 mmol/l during the first week of life were analyzed in relation to clinical data and MRI (1.5 T). The MRI evaluation included: visual scoring of gray and white matter abnormalities; measurement of apparent diffusion coefficient (ADC) in periventricular white matter, basal ganglia and pons, and a newly developed method for semi-automatic segmentation of brain volumes. MRI data were analyzed without knowledge of clinical data. No infant had IVH grade 3–4. No infant received insulin. Follow up at 2.5 years of corrected age is ongoing; data including Bayley Scales of Infant Development (BSID-III) was available in 45 infants.

Results: Clinical data are shown in the table. Significant (p < 0.05) univariate correlations were found between GA, BW, days on mechanical ventilation, highest blood glucose levels on days 2–5 and number of days with glucose >8.3 mmol/l, PVL and white matter volume. Days with glucose >8.3 mmol/l correlated independently with reduced white matter volume (p = 0.045), but not GA and days on mechanical ventilation. When BW was included in the analysis, days with glucose >8.3 mmol/l reached borderline significance (p = 0.068), but no other factor reached significance. For PVL, days of mechanical ventilation was the only independently associated factor (p = 0.012). In the 45 infants with follow up, only days with glucose >8.3 mmol/l was independently associated with a lower motor index on BSID-III.

Conclusion: Prolonged duration of high blood glucose >8.3 mmol/l during the first week of life in very preterm infants is associated with reduced white matter volume and may also be associated with poorer motor performance at 2.5 years.

National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-333331 (URN)10.1111/apa.13877/full (DOI)000405213500022 ()
Available from: 2017-11-15 Created: 2017-11-15 Last updated: 2017-11-15Bibliographically approved
Kaul, Y. F., Rosander, K., Hofsten, von, C., Brodd, K. S., Holmström, G., Kaul, A., . . . Hellström-Westas, L. (2016). Visual tracking in very preterm infants at 4 months predicts neurodevelopment at 3 years of age. Pediatric Research, 80(1), 35-42
Open this publication in new window or tab >>Visual tracking in very preterm infants at 4 months predicts neurodevelopment at 3 years of age
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2016 (English)In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 80, no 1, p. 35-42Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Typically developing infants track moving objects with eye and head movements in a smooth and predictive way at 4 mo of age, but this ability is delayed in very preterm infants. We hypothesized that visual tracking ability in very preterm infants predicts later neurodevelopment. METHOD: In 67 very preterm infants (gestational age<32wk), eye and head movements were assessed at 4 mo corrected age while the infant tracked a moving object. Gaze gain, smooth pursuit, head movements, and timing of gaze relative the object were analyzed off line. Results of the five subscales included in the Bayley Scales of Infant Development (BSID-III) at 3 y of age were evaluated in relation to the visual tracking data and to perinatal risk factors. RESULTS: Significant correlations were obtained between gaze gain and cognition, receptive and expressive language, and fine motor function, respectively, also after controlling for gestational age, severe brain damage, retinopathy of prematurity, and bronchopulmonary dysplasia. CONCLUSION: This is the first study demonstrating that the basic ability to visually track a moving object at 4 mo robustly predicts neurodevelopment at 3 y of age in children born very preterm.

National Category
Psychology Pediatrics Ophthalmology
Identifiers
urn:nbn:se:uu:diva-284105 (URN)10.1038/pr.2016.37 (DOI)000379377900006 ()27027722 (PubMedID)
Available from: 2016-04-15 Created: 2016-04-15 Last updated: 2017-11-30
Bolk, J., Kaul, Y. F., Hellström-Westas, L., Stjernqvist, K., Padilla, N., Serenius, F., . . . Aden, U. (2016). Visual-Motor Integration In Extremely Preterm Born Children In Sweden. European Journal of Pediatrics, 175(11), 1530-1530
Open this publication in new window or tab >>Visual-Motor Integration In Extremely Preterm Born Children In Sweden
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2016 (English)In: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 175, no 11, p. 1530-1530Article in journal (Refereed) Published
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-315013 (URN)000390040700390 ()
Available from: 2017-02-08 Created: 2017-02-08 Last updated: 2017-11-29Bibliographically approved
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