The panorama of cerebral palsy after very and extremely preterm birth: evidence and challenges.

During the past 2 decades, major advances in maternal-fetal medicine and neonatology have resulted in unprecedented survival of very preterm (<32 weeks) and extremely preterm (<28 weeks) babies. Despites these advances in prenatal care, neurodevelopmental motor impairment remains a substantial sequela. This article describes the major progress and challenges in understanding pathways of preterm children who go on to have one of the cerebral palsy syndromes. The contributions of chronic lung disease, intraventricular hemorrhage, retinopathy of prematurity, and postnatal steroids are analyzed. Management can then be directed to limiting the comorbidities that are associated with threats to survival and to improving protection of central nervous system functions that are involved in moving, manipulative skills, feeding, communication, and learning.