Have outcomes following extremely preterm birth improved over time?

Area of Science:

• Neonatal care
• Developmental neuroscience
• Public health

Background:

• Improved survival rates for extremely preterm infants (<28 weeks' gestation) mean more individuals are reaching school age.
• Preterm birth is a known risk factor for neurodevelopmental deficits.
• Advances in perinatal care have enhanced survival but their impact on long-term neurodevelopment is unclear.

Purpose of the Study:

• To review the impact of advances in perinatal care on long-term neurodevelopmental outcomes in preterm infants.
• To assess temporal trends in neurodevelopmental deficits among school-aged children born preterm.

Main Methods:

• Systematic review of published studies examining temporal changes in neurodevelopmental outcomes.
• Focus on data from high-income countries due to study limitations.
• Analysis of outcomes including neurosensory, cognitive, academic, motor, and executive functions.

Main Results:

• No clear positive trend in school-age neurodevelopmental outcomes (neurosensory, cognitive, academic, motor, executive function) over time.
• Potential decrease in cerebral palsy rates observed.
• Limited data available, primarily from high-income countries.

Conclusions:

• Despite improved survival, advances in perinatal care have not demonstrably improved long-term neurodevelopmental outcomes at school age.
• Cerebral palsy rates may be declining, suggesting some positive impact.
• Further research is crucial to understand trends and investigate other outcomes like mental health and behavior.