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Neurologic and metabolic issues in moderately preterm, late preterm, and early term infants

Abbot R Laptook1

  • 1Department of Pediatrics, Women & Infants Hospital of Rhode Island, The Warren Alpert Medical School of Brown University, 101 Dudley Street, Providence, RI 02905, USA.

Clinics in Perinatology
|November 5, 2013
PubMed

Insights

Neurologic issues like brain bleeds are rare in moderately preterm infants. Feeding difficulties, however, are the main concern, stemming from challenges in coordinating suck, swallow, and breathing.

Area of Science:

  • Neonatal neurology
  • Developmental pediatrics

Background:

  • Very preterm and extremely preterm infants face significant neurologic risks, including intracranial hemorrhage, white matter injury, and apnea.
  • These severe morbidities are less frequent in moderately preterm and late preterm infants.

Purpose of the Study:

  • To investigate the spectrum and frequency of neurologic morbidities in moderately and late preterm infants.
  • To identify the primary neurologic challenges faced by these infants.

Main Methods:

  • Review of existing literature and surveillance data on neuroimaging in preterm infants.
  • Analysis of reported frequencies of specific neurologic conditions.
  • Identification of feeding difficulties as a key outcome measure.

Main Results:

  • Germinal matrix hemorrhage-intraventricular hemorrhage and white matter injury occur infrequently in moderately and late preterm infants, though precise frequencies are difficult to ascertain due to selection bias in neuroimaging.
  • Feeding difficulties, related to the integration of suck, swallow, and breathing, represent the most common neurologic morbidity in this population.

Conclusions:

  • While severe neurologic injuries are uncommon, moderately and late preterm infants frequently experience feeding challenges.
  • The developmental integration of suck, swallow, and breathing is a critical factor in the neurologic well-being and feeding success of these infants.

Keywords:
ApneaFeeding abilityIntracranial hemorrhageNeurologic morbiditiesPeriventricular leukomalaciaSuck-swallow-breathing coordination

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