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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopmental outcomes of preterm infants: a recent literature review
Estefani Hee Chung1, Jesse Chou1, Kelly A Brown1
1Homer Stryker MD School of Medicine, Western Michigan University, Kalamazoo, MI, USA.
Insights
Neonatal Intensive Care Unit (NICU) advancements improve preterm infant survival. While historically at higher risk for neurodevelopmental issues, recent data suggests lower rates, emphasizing early intervention and ongoing monitoring for premature infants.
Area of Science:
- Neonatal care and developmental pediatrics.
- Neurodevelopmental outcomes in premature infants.
- Long-term effects of prematurity.
Background:
- Neonatal Intensive Care Unit (NICU) technology has improved preterm infant survival rates.
- Premature infants face potential risks including behavioral, motor, sensory, and developmental issues.
- Research findings on the long-term outcomes of preterm infants are mixed.
Purpose of the Study:
- To review the neurodevelopmental outcomes of preterm infants.
- To assess the impact of NICU care and prematurity on long-term development.
- To identify trends in neurodevelopmental conditions among preterm populations.
Main Methods:
- Literature search of PubMed for articles published between January 2018 and September 2019.
- Selection of studies focusing on preterm infants with uncomplicated NICU courses.
- Inclusion of studies without extensive medical interventions.
Main Results:
- Historically, preterm infants showed higher risks for ADHD, depression, anxiety, ASD, and personality disorders compared to full-term infants.
- Greater gestational age and birth weight correlate with lower risk of developmental delay; motor impairment can decrease over time.
- Factors like adverse childhood experiences, socioeconomic status, and parental education influence developmental outcomes; hearing/vision deficits are infrequent but linked to ototoxic agents and PDA.
Conclusions:
- Preterm infants remain at higher risk for adverse neurodevelopmental outcomes than full-term infants.
- Recent trends indicate potentially lower rates of certain neurodevelopmental conditions compared to historical data.
- Early identification and intervention are crucial for preterm infants with developmental or mental health concerns, with continued monitoring recommended.
Background:
Over the past several decades, improvements in technology in the Neonatal Intensive Care Unit (NICU) have led to improved survival of preterm infants. Some studies have found that premature infants are at higher risk of behavioral problems, motor and sensory abnormalities, developmental delay, and poorer academic performance, while other studies have found no significant difference.
Methods:
A literature search was conducted through PubMed for articles published between January 2018 and September 2019. Studies that concentrated on preterm infants with relatively uncomplicated NICU courses and without extensive medical interventions were selected.
Results:
Historically, preterm infants have been found to be at increased risk for the inattentive subtype of attention deficit hyperactivity disorder (ADHD), depression, anxiety, autism spectrum disorder (ASD), avoidant personality, and anti-social personality, when compared to full term infants. However, some studies found that this difference between the two groups decrease as they enter adolescence and adulthood. Preterm infants are at increased risk for language, cognitive, sensory and motor deficits. Greater gestational age (GA) at birth and higher birth weight is associated with a lower risk of developmental delay. Cohort studies focusing on motor development showed that the degree of impairment decreased over time. Adverse childhood experiences (ACEs) have a negative correlation on multiple domains of development. The overall outcome of these infants may be influenced by socioeconomic status (SES), neonatal morbidities, demographics and parental education. Hearing and vision deficits are relatively infrequent among premature infants. A significant risk factor for hearing impairment involves the use of ototoxic agents such as gentamicin and infants with a patent ductus arteriosus (PDA).
Conclusions:
Preterm infants are at higher risk of adverse neurodevelopmental outcomes when compared to their full-term counter parts. However, in recent years it appears that rates of certain neurologic and developmental conditions are occurring in rates lower than historically noted. Premature individuals with possible developmental or mental health concerns should be identified early on so that interventions can be implemented immediately. Those meeting developmental milestone should continue to be monitored closely as deficits may develop later.
