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Have outcomes following extremely preterm birth improved over time?

Jeanie Ly Cheong1, Alicia J Spittle2, Alice C Burnett3

  • 1Level 7, Newborn Research, Royal Women's Hospital, 20 Flemington Road, Parkville, VIC, 3052, Australia; Victorian Infant Brain Studies, Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Rd, Parkville, VIC, 3052, Australia; Level 7, Dept of Obstetrics & Gynaecology, University of Melbourne, Royal Women's Hospital, 20 Flemington Road, Parkville, VIC, 3052, Australia.

Seminars in Fetal & Neonatal Medicine
|May 27, 2020
PubMed

Insights

Advances in perinatal care have improved survival for extremely preterm infants, but long-term neurodevelopmental outcomes show no definite improvement over time. Cerebral palsy rates may be decreasing, warranting further research.

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.

Keywords:
Academic functionCerebral palsyCognitive functionExtremely low birthweightExtremely pretermMotor impairment

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