Marilee C Allen1. 1. The Johns Hopkins School of Medicine, Baltimore, Maryland 21287-3200, USA. mallen2@jhmi.edu
Abstract
PURPOSE OF REVIEW: Preterm birth is emerging as a major public health problem in the USA. Improvements in preterm birth and survival rates translate to increasing numbers of preterm survivors, and many develop motor, cognitive and sensory impairments. RECENT FINDINGS: The review discusses the recently reported prevalence of neurodevelopmental disabilities in preterm survivors, in addition to studies of factors associated with neurodevelopmental outcome. SUMMARY: A 2007 report from the Institute of Medicine emphasizes preterm birth as an increasingly common complex condition with multiple risk factors resulting from multiple gene-environmental interactions, leading to birth before 37 weeks gestation, neonatal complications and a disproportionately high contribution to neurodevelopmental disability rates. The increased risk of cerebral palsy with decreasing gestational age categories is well documented, but recent studies highlight the range and severity of cognitive, sensory, language, visual-perceptual, attention and learning deficits in very preterm children. Combined with increasingly sophisticated neuroimaging studies to identify perinatal risk factors, neurodevelopmental follow-up of neonatal intensive care unit trials offers the potential to really improve our understanding of how the preterm brain develops, is injured and recovers from injuries. Knowledge of what influences neurodevelopmental outcomes is key to developing better treatment strategies.
PURPOSE OF REVIEW: Preterm birth is emerging as a major public health problem in the USA. Improvements in preterm birth and survival rates translate to increasing numbers of preterm survivors, and many develop motor, cognitive and sensory impairments. RECENT FINDINGS: The review discusses the recently reported prevalence of neurodevelopmental disabilities in preterm survivors, in addition to studies of factors associated with neurodevelopmental outcome. SUMMARY: A 2007 report from the Institute of Medicine emphasizes preterm birth as an increasingly common complex condition with multiple risk factors resulting from multiple gene-environmental interactions, leading to birth before 37 weeks gestation, neonatal complications and a disproportionately high contribution to neurodevelopmental disability rates. The increased risk of cerebral palsy with decreasing gestational age categories is well documented, but recent studies highlight the range and severity of cognitive, sensory, language, visual-perceptual, attention and learning deficits in very preterm children. Combined with increasingly sophisticated neuroimaging studies to identify perinatal risk factors, neurodevelopmental follow-up of neonatal intensive care unit trials offers the potential to really improve our understanding of how the preterm brain develops, is injured and recovers from injuries. Knowledge of what influences neurodevelopmental outcomes is key to developing better treatment strategies.
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