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Published on: November 20, 2015
[Severe sensorineural impairment in very premature infants: epidemiological aspects]
1Inserm U149, Unité de Recherches Epidémiologiques en Santé Périnatale et Santé des Femmes, 123, boulevard de Port-Royal, 75014 Paris, France.
Insights
Very preterm infants face a high risk of neurodevelopmental disabilities, including cerebral palsy and cognitive impairments. Survival rates have increased, but long-term outcomes require careful consideration.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Public Health
Context:
- Perinatal care advancements have increased survival rates for very preterm infants.
- Concerns exist regarding the long-term neurodevelopmental outcomes of these infants.
- This review examines motor, sensory, and cognitive impairments in survivors.
Purpose:
- To review prevalence estimates of neurodevelopmental impairments in very preterm infants.
- To analyze recent time-trends of these impairments.
- To synthesize data from European, Australian, and North American studies.
Summary:
- Cerebral palsy prevalence is highest in extremely preterm (<28 weeks) and very preterm (28-31 weeks) infants.
- Prevalence of cerebral palsy has remained stable since 1990 for extremely and very preterm infants.
- Moderate to severe cognitive impairments affect 15-25% of very preterm children; severe hearing/visual loss affects <4%.
Impact:
- Very preterm infants exhibit a significant risk for various disabilities.
- Findings highlight the need for ongoing monitoring and support for this population.
- Caution is advised when generalizing findings from older studies (1985-1995) to current cohorts.
Objective:
Advances in perinatal care have resulted in a sharply increasing survival rate among very preterm infants. However, there is some concern about the later neurodevelopmental outcome of those infants who survive. In this paper, we review the prevalence estimates of motor (cerebral palsy), sensorineural and cognitive impairments and their recent time-trends in very preterm infants.
Method:
A review of studies describing neurodevelopmental outcome of very preterm infants in Europe, Australia and America North.
Results:
The gestational age-specific prevalences of cerebral palsy (CP) were 72-86 for extremely preterm children (<28 weeks), 32-60 for very preterm (28-31 weeks) and 5-6 for moderate preterm (32-36 weeks), and 1.3-1.5 for term children per 1000. The live birth prevalence for CP remained unchanged in extremely and very preterm infants since 1990. The prevalence estimates of moderate and severe cognitive impairments are 15 to 25% in very preterm children. Less than 4% of very preterm infants develop severe hearing or visual loss.
Conclusion:
This review indicates that very preterm infants have high risk of disability. Most studies have been conducted between 1985 and 1995. Thus, these results should be interpreted with caution before generalisation to recent cohorts.
