Neurodevelopmental outcomes of preterm infants: a recent literature review

Abstract

Background: Over the past several decades, improvements in technology in the Neonatal Intensive Care Unit (NICU) have led to improved survival of preterm infants. Some studies have found that premature infants are at higher risk of behavioral problems, motor and sensory abnormalities, developmental delay, and poorer academic performance, while other studies have found no significant difference.Methods: A literature search was conducted through PubMed for articles published between January 2018 and September 2019. Studies that concentrated on preterm infants with relatively uncomplicated NICU courses and without extensive medical interventions were selected.Results: Historically, preterm infants have been found to be at increased risk for the inattentive subtype of attention deficit hyperactivity disorder (ADHD), depression, anxiety, autism spectrum disorder (ASD), avoidant personality, and anti-social personality, when compared to full term infants. However, some studies found that this difference between the two groups decrease as they enter adolescence and adulthood.Preterm infants are at increased risk for language, cognitive, sensory and motor deficits. Greater gestational age (GA) at birth and higher birth weight is associated with a lower risk of developmental delay. Cohort studies focusing on motor development showed that the degree of impairment decreased over time. Adverse childhood experiences (ACEs) have a negative correlation on multiple domains of development. The overall outcome of these infants may be influenced by socioeconomic status (SES), neonatal morbidities, demographics and parental education. Hearing and vision deficits are relatively infrequent among premature infants. A significant risk factor for hearing impairment involves the use of ototoxic agents such as gentamicin and infants with a patent ductus arteriosus (PDA).Conclusions: Preterm infants are at higher risk of adverse neurodevelopmental outcomes when compared to their full-term counter parts. However, in recent years it appears that rates of certain neurologic and developmental conditions are occurring in rates lower than historically noted. Premature individuals with possible developmental or mental health concerns should be identified early on so that interventions can be implemented immediately. Those meeting developmental milestone should continue to be monitored closely as deficits may develop later.

Prevalence of Language Delay among Healthy Preterm Children, Language Outcomes and Predictive Factors

“…Among biomedical factors, gestational age or birth weight were found to have a predictive effect on language delay, and the risk of suffering language impairments [9,10,23,37,38]. Other authors, however, have suggested that neurobehavioral outcomes at an early school age can be predicted based on IVH incidence as opposed to birth weight or GA [39].…”

Morbidity of radical hysterectomy combined with caesarean section in pregnant patients with cervical cancer

“…Despite the prematurity, our neonatal survival rate was 100%. Nevertheless, preterm birth is associated with an increased risk for adverse neurodevelopmental outcomes [19]. Therefore, considerations on fetal maturity and a delay of a potentially curative maternal treatment should be carefully made in a multidisciplinary team.…”

Germinal Matrix-Intraventricular Hemorrhage of the Preterm Newborn and Preclinical Models: Inflammatory Considerations

“…A preterm newborn (PTNB) is the one born before 37 weeks gestation, considering that a normal gestation lasts for 280 ± 15 days [1]. Depending on the gestational age, PTNB can be classified as extremely preterm (<28 gestational weeks), very preterm (28 ≥ 32 gestational weeks), moderately preterm (32-33 gestational weeks) and late preterm (34-36 gestational weeks) [2,3]. In addition, according to the weight at birth, newborns can be classified into low weight (<2500 g), very low weight (<1500 g) and extremely low weight (<1000 g) [4].…”