Preterm birth–associated neurodevelopmental impairment estimates at regional and global levels for 2010

Abstract

Background:In 2010, there were an estimated 15 million preterm births worldwide (<37 wk gestation). Survivors are at risk of adverse outcomes, and burden estimation at global and regional levels is critical for priority setting.Methods:Systematic reviews and meta-analyses were undertaken to estimate the risk of long-term neurodevelopmental impairment for surviving preterm babies according to the level of care. A compartmental model was used to estimate the number of impaired postneonatal survivors following preterm birth in 2010. A separate model (DisMod-MR) was used to estimate years lived with disability (YLDs) for the global burden of disease 2010 study. Disability adjusted life years (DALYs) were calculated as the sum of YLDs and years of life lost (YLLs).Results:In 2010, there were an estimated 13 million preterm births who survived beyond the first month. Of these, 345,000 (2.7%, uncertainty range: 269,000–420,000) were estimated to have moderate or severe neurodevelopmental impairment, and a further 567,000 (4.4%, (445,000–732,000)) were estimated to have mild neurodevelopmental impairment. Many more have specific learning or behavioral impairments or reduced physical or mental health. Fewest data are available where the burden is heaviest. Preterm birth was responsible for 77 million DALYs, 3.1% of the global total, of which only 3 million were YLDs.Conclusion:Most preterm births (>90%) survive without neurodevelopmental impairment. Developing effective means of prevention of preterm birth should be a longer term priority, but major burden reduction could be made immediately with improved coverage and quality of care. Improved newborn care would reduce mortality, especially in low-income countries and is likely to reduce impairment in survivors, particularly in middle-income settings.

Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI): an extension of the STROBE statement for neonatal infection research

“…However we recognise that other important long-term outcomes, such as neurological impairment, are increasingly being assessed, and are important to include. 55 Reporting guidance for impairment outcomes after neonatal infection as well as other common neonatal complications, such as preterm birth, 56 is an area for future development.…”

Third Trimester Brain Growth in Preterm Infants Compared With In Utero Healthy Fetuses

“…1 Brain injury is a common complication of preterm birth and is diagnosed by using conventional neuroimaging techniques in about one-third of preterm infants. 2 However, the presence of structural brain injury alone does not account for the frequency and scope of neurodevelopmental impairments in surviving preterm infants.…”

Twenty-year Follow-up of Kangaroo Mother Care Versus Traditional Care

“…1 According to the World Health Organization, 10% of all births worldwide are either low birth weight or premature (ie, birth at <37 weeks of gestational age). Preterm survivors more frequently exhibit neurologic and behavioral impairment, 2 and premature or low birth weight infants (LBWI) later have cognitive deficits, poor academic performance, or attention problems. 3 -5 At school age, they are less socially competent and more often victimized than their peers, 6 and, in adolescence, they are more often socially rejected and less attentive.…”