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The impact of extrauterine life on visual maturation in extremely preterm born infants
Eva Schwindt1, Vito Giordano2, Zsofia Rona2
1Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Pediatric Intensive Care and Neuropediatrics, Waehringer Guertel 18-20, 1090, Vienna, Austria. eva.schwindt@meduniwien.ac.at.
Insights
Extrauterine life accelerates visual system maturation in preterm infants. Longer postnatal age, after reaching a maturational threshold, leads to shorter visual evoked potential (VEP) peak-times.
Area of Science:
- Neuroscience
- Developmental Biology
- Ophthalmology
Background:
- Brain maturation is significantly influenced by extrauterine life.
- Limited research exists on visual evoked potential (VEP) development in extremely preterm infants, particularly concerning extrauterine influences.
- Understanding VEP maturation is crucial for assessing visual system development in this vulnerable population.
Purpose of the Study:
- To determine normal VEP maturation in infants born before 29 weeks gestational age (GA).
- To investigate the impact of extrauterine life on VEP development in extremely preterm infants.
Main Methods:
- Prospective recording of VEPs in extremely preterm infants.
- Identification of principal VEP peaks (N0, N1, P1, N2, P2, N3).
- Assessment of peak-time and peak appearance percentages across different gestational age groups and postnatal ages up to 8 weeks.
Main Results:
- VEP peak-times decreased with increasing gestational age at birth.
- Infants with longer postnatal age (extrauterine life) showed shorter VEP peak-times, indicating accelerated maturation.
- This acceleration effect was less pronounced in infants born before 25 weeks GA.
Conclusions:
- Extrauterine life appears to accelerate visual system maturation in preterm infants once a certain developmental threshold is achieved.
- Postnatal age is a significant factor in VEP maturation beyond gestational age.
- Findings highlight the importance of considering extrauterine environment in assessing visual development in extremely preterm infants.
Background:
Extrauterine life is an important factor when considering brain maturation. Few studies have investigated the development of visual evoked potentials (VEP) in extremely preterm infants, and only a minority have taken into consideration the impact of extrauterine life. The aim of this study was to assess the normal maturation of VEP in infants born prior to 29 weeks gestational age (GA) and to explore the potential influence of extrauterine life.
Methods:
VEP were prospectively recorded in extremely preterm infants, and principal peaks (N0, N1, P1, N2, P2, N3) were identified. The mean of peak-time and percentages of peak appearances were assessed for three GA groups (23/24, 25/26, 27/28 weeks) and four subgroups of increasing postnatal age (PNA), up to 8 weeks after birth.
Results:
A total of 163 VEP recordings in 38 preterm infants were analyzed. With increasing GA at birth, peak-times decreased. When comparing infants with equal GA but longer extrauterine life, those with the highest PNA demonstrated the shortest VEP peak-times. However, this effect was less present in infants born prior to 25 weeks GA.
Conclusion:
Provided that a certain maturational threshold is reached, extrauterine life appears to accelerate maturation of the visual system in preterm infants.
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