Premature babies with serious brain haemorrhages were twice as likely to survive without severe learning disabilities when treated with a pioneering technique, a study has found.
Researchers in Bristol developed the drainage, irrigation and fibrinolytic therapy (Drift) technique in 1998 and it was first trialled in 2003.
They say it is the only treatment to objectively benefit infants with serious brain haemorrhage, known as intraventricular haemorrhage (IVH), which can lead to severe learning impairment and cerebral palsy.
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The surgical technique aimed to reduce disability in premature babies with serious brain haemorrhage by washing out the ventricles in the brain to remove potentially toxic fluid and reduce pressure.
A 10-year follow-up study, funded by the National Institute for Health Research, saw researchers assess 52 of the 65 survivors of the original cohort of 77 premature babies with severe brain haemorrhage who took part in the randomised controlled trial.
Of these, 39 babies received the Drift intervention and 38 received standard treatment, which uses lumbar punctures to control expansion of the ventricles and reduce pressure.
The results of this study clearly demonstrate that secondary severe brain injury is reduced in preterm infants by using this neonatal intervention, and importantly, this is sustained into middle school-age
Dr Karen Luyt
The research team, led by Bristol Medical School, traced and assessed the children at age 10.
They found those who received Drift were almost twice as likely to survive without severe cognitive disability and more likely to attend mainstream education than those who received standard treatment.
Dr Karen Luyt, reader in neonatal medicine at Bristol Medical School, said: “Bleeding in the brain is one of the most serious complications of preterm birth and premature babies are particularly at risk of bleeding, the condition can cause significant brain injury leading to subsequent severe learning disabilities.
“While a two-year follow-up study showed reduced rates of severe cognitive disability, it was important for us to assess whether the Drift intervention had longer-term benefits.
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She added: “The results of this study clearly demonstrate that secondary severe brain injury is reduced in preterm infants by using this neonatal intervention, and importantly, this is sustained into middle school-age.
“We hope that these results will be used to inform UK and international healthcare guidelines and support implementation of Drift as a clinical service to help improve outcomes for vulnerable babies.
“We would also like to thank the families and the children who took part in the study for their support and significant contribution that has helped advance our treatment of this condition.”
The follow-up study used results from cognitive, vision, movement and behaviour assessments as well as interviews with parents or guardians and educational attainment scores.
Are babies born with a sense of right and wrong?
Asked by: Luc Wallace, Canterbury
Early theorists in psychology mainly took the approach that babies are born without any sense of morality and have to learn it as they get older. We now know that although a fully developed sense of morality does not emerge until adolescence or later, babies already show signs of a rudimentary moral compass.
Consider a 2010 study by researchers at Yale University that involved babies as young as three months old watching a live ‘show’ of different shaped wooden blocks on a hill (the shapes corresponded to different characters, who either helped or hindered another character who was struggling to get up the hill). The researchers found that the babies preferred looking at the helpful characters, suggesting early preference for altruistic social behaviour.
Similar research with five-month-olds has shown that they have a sense of ‘justified retribution’: they prefer characters who hinder a previously obstructive individual rather than help them.
A sense of fairness also emerges early. In a study last year by researchers at the University of Washington, 13-month-old babies watched a researcher who distributed crackers fairly or unfairly among two other adults. When the infants were given a chance to interact with the researcher, they were more inclined to interact with a fair researcher than an unfair one, indicating that they had a preference for fairness.
Finally, a cute line of research has looked at babies’ inclination to respond to the needs of others, showing that already by age one they will offer comfort to a person who has hurt themselves, or try to help someone obtain an item that’s out of reach. The spontaneity of these behaviours has led scientists to believe that a sense of right and wrong is not entirely learned, but rather indicative of an evolved predisposition towards moral goodness.
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