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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Early neurodevelopmental outcomes of extremely preterm infants
Elizabeth E Rogers1, Susan R Hintz2
1Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, 550 4th St, 5th Floor, Box 0743, San Francisco, CA 94143.
Insights
Extremely preterm infants face high risks of death and disability. Despite survival improvements, early neurodevelopmental outcomes remain a concern, necessitating targeted interventions for better long-term results.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Neuroscience
Background:
- Infants born at extreme preterm gestation are at significant risk for mortality and neurodevelopmental impairments.
- While survival rates have improved, substantial gains in early neurodevelopmental outcomes for this vulnerable population have not been observed.
- Extreme prematurity is an independent risk factor for adverse development, characterized by considerable variability in impairment types and severity.
Purpose of the Study:
- To review the rates and types of neurodevelopmental impairments in extremely preterm infants.
- To focus on early outcomes within the first 18-36 months of life.
- To highlight the importance of understanding these impairments for developing targeted interventions.
Main Methods:
- Literature review of studies examining neurodevelopmental outcomes in extremely preterm infants.
- Analysis of neurodevelopmental impairments including neurosensory, motor, cognitive, and behavioral outcomes.
- Focus on early developmental assessments within the first three years of life.
Main Results:
- Improved survival rates for extremely preterm infants have not translated into commensurate improvements in early neurodevelopmental outcomes.
- A range of neurodevelopmental impairments, including neurosensory, motor, cognitive, and behavioral deficits, are prevalent.
- Significant variability exists in the type and severity of impairments observed among these infants.
Conclusions:
- Early neurodevelopmental outcomes in extremely preterm infants remain a critical concern despite advances in neonatal care.
- The long-term neurodevelopmental effects of extreme prematurity can extend beyond early childhood.
- Understanding the prevalence and nature of these impairments is crucial for guiding interventions aimed at improving long-term outcomes.
Abstract:
Infants born at extreme preterm gestation are at risk for both death and disability. Although rates of survival have improved for this population, and some evidence suggests a trend toward decreased neuromotor impairment over the past decades, a significant improvement in overall early neurodevelopmental outcome has not yet been realized. This review will examine the rates and types of neurodevelopmental impairment seen after extremely preterm birth, including neurosensory, motor, cognitive, and behavioral outcomes. We focus on early outcomes in the first 18-36 months of life, as the majority of large neonatal studies examining neurodevelopmental outcomes stop at this age. However, this early age is clearly just a first glimpse into lifetime outcomes; the neurodevelopmental effects of extreme prematurity may last through school age, adolescence, and beyond. Importantly, prematurity appears to be an independent risk factor for adverse development, but this population demonstrates considerable variability in the types and severity of impairments. Understanding both the nature and prevalence of neurodevelopmental impairment among extremely preterm infants is important because it can lead to targeted interventions that in turn may lead to improved outcomes.
