[Prevention of brain injury in preterm born infants]

Area of Science:

• Neonatal neurology
• Perinatal brain injury

Background:

• Visible brain injuries, including intraventricular haemorrhage and periventricular leucomalacia, are significant contributors to neurodevelopmental impairment in preterm infants, accounting for one-third of cases.
• Despite extensive research, specific preventive measures implemented after birth have not consistently demonstrated efficacy.

Purpose of the Study:

• To review the impact of visible brain injuries on neurodevelopmental outcomes in preterm infants.
• To discuss the trends in brain injury risk and potential reasons for observed changes.

Main Methods:

• Review of existing literature on brain injury in preterm infants.
• Analysis of trends in the incidence of specific brain injury types.
• Discussion of the role of pathophysiological understanding in clinical management.

Main Results:

• Intraventricular haemorrhage, periventricular leucomalacia, post-haemorrhagic ventriculomegaly, and cerebral atrophy are key "visible" brain injuries.
• A decrease in the risk of brain injury has been observed over time.
• The success of specific preventive measures after birth remains unproven.

Conclusions:

• Improved understanding of pathophysiology has led to more adapted support of vital functions, potentially contributing to reduced brain injury risk.
• Continued research is needed to identify effective preventive strategies for neonatal brain injury.