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The case of late preterm birth: sliding forwards the critical window for cognitive outcome risk
Giovanni Mento1, Chiara Nosarti1
11 Department of Developmental and Social Psychology (DPSS), University of Padua, Padua, Italy ; 2 Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Insights
Preterm birth survivors often face neurodevelopmental challenges. Environmental factors like education may influence long-term cognitive outcomes in late preterm infants.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Preterm birth survivors frequently experience neurodevelopmental disabilities and subtle neuropsychological deficits.
- Current assessment tools may not detect subtle cognitive impairments in childhood.
- Late preterm birth (34-36 weeks) is increasingly linked to altered brain maturation and neurocognitive implications.
Purpose of the Study:
- To explore the interplay of nature and nurture in the neurocognitive development of preterm infants.
- To investigate how environmental factors, such as educational attainment, may moderate the effects of late preterm birth on aging-related neuropsychological impairments.
Main Methods:
- Review of clinical literature on neurocognitive development in preterm infants.
- Synthesis of recent neuroimaging evidence on brain maturation in preterm and late preterm populations.
- Exploration of the "nature-nurture" interaction in lifespan neurocognitive outcomes.
Main Results:
- Late preterm birth is associated with altered brain maturation and potential long-term neurocognitive consequences.
- Environmental factors, like education, may play a moderating role in the relationship between late preterm birth and cognitive aging.
- Existing clinical tools may lack sensitivity for detecting subtle, emerging cognitive impairments in this population.
Conclusions:
- A comprehensive understanding of preterm infant neurodevelopment requires considering both genetic and environmental influences.
- Further research is needed to refine assessment methods for subtle cognitive deficits in late preterm children.
- Interventions focusing on environmental factors may mitigate long-term neurocognitive risks associated with preterm birth.
Abstract:
Many survivors of preterm birth experience neurodevelopmental disabilities, such as cerebral palsy, visual and hearing problems. However, even in the absence of major neurological complications, premature babies show significant neuropsychological and behavioural deficits during childhood and beyond. While the clinical tools routinely used to assess neurocognitive development in those infants have been useful in detecting major clinical complications in early infancy, they have not been equally sensitive in identifying subtle cognitive impairments emerging during childhood. These methodological concerns become even more relevant when considering the case of late preterm children (born between 34 and 36 gestational weeks). Although these children have been traditionally considered as having similar risks for developmental problems as neonates born at term, a recent line of research has provided growing evidence that even late preterm children display altered structural and functional brain maturation, with potential life-long implications for neurocognitive functioning. A recent study by Heinonen put forward the hypothesis that environmental factors, in this case educational attainment, could moderate the association between late preterm birth (LPT) and neuropsychological impairments commonly associated with aging. In this paper we bring together clinical literature and recent neuroimaging evidence in order to provide two different but complementary approaches for a better understanding of the "nature-nurture" interplay underlying the lifespan neurocognitive development of preterm babies.
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