[Grand prematurity, risk of neuropsychic handicaps and neuroprotection]

S Marret1, L Marpeau

  • 1Clinique de Pédiatrie et de Puériculture, Service de Médecine Néonatale, Hôpital Charles-Nicolle, Rouen.

Insights

Preterm infants face high risks of cerebral palsy and neurodevelopmental issues. New strategies focus on preventing brain lesions through infection control and neuroprotection.

Area of Science:

  • Neonatal neurology
  • Developmental neurobiology
  • Neuroepidemiology

Context:

  • While survival rates for very and extremely preterm infants have improved, they remain vulnerable to significant neurodevelopmental challenges.
  • Cerebral palsy, neuromotor dysfunction, and cognitive impairments are prevalent risks in this population.
  • Periventricular white matter lesions (hemorrhagic or necrotic) pose a critical threat to the developing preterm brain.

Purpose:

  • To explore the multifactorial pathophysiology of brain lesions in preterm infants.
  • To highlight the importance of early infection detection and management.
  • To introduce novel neuroprotective strategies for preventing cerebral palsy.

Summary:

  • Improved survival of preterm infants does not negate the risk of neurodevelopmental sequelae, particularly cerebral palsy.
  • Brain lesions in the periventricular white matter are a primary concern for developing brains of preterm neonates.
  • Advances in neuroimaging, neurobiology, and epidemiology enable a deeper understanding of brain lesion development.

Impact:

  • Early detection and treatment of infections are crucial for preventing brain injury.
  • Neuroprotective agents targeting excitotoxicity, free radicals, and inflammation offer promising avenues for cerebral palsy prevention.
  • This research informs strategies to mitigate long-term neurological deficits in preterm survivors.

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