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Neurodevelopmental outcomes of extremely preterm infants: theoretical and epidemiological perspectives to guide shared-care decision-making

Neurodevelopmental outcomes of extremely preterm infants: theoretical and epidemiological perspectives to guide shared-care decision-making
Neurodevelopmental outcomes of extremely preterm infants: theoretical and epidemiological perspectives to guide shared-care decision-making
Although births below 28 completed weeks' of gestation contribute to less than 1% of all preterm births globally, the impact of extreme prematurity (EPT) on neurodevelopmental outcomes across the life-course is disproportionately large. Higher rates and increased severity of neurodevelopmental impairments (NDIs) are reported among extremely preterm infants (EPIs). Cognitive skills, motor skills (manifesting as cerebral palsy) and vision are most commonly affected, with effects pervasive throughout school, adolescence and early adulthood. In addition, poorer academic outcomes and higher rates of psychiatric morbidity are seen among EPTs. Consistent improvements in EPI survival in recent years has not been matched with improvements in neurodevelopmental outcomes, especially for those born at less than 25 gestational weeks. However, over the last 20 years, several national and cross-national cohort studies have helped advance our understanding of extreme prematurity's developmental and life-course consequences. Here we provide an overview of the key findings from 13 multi-centre cohorts measuring neurodevelopmental outcomes and discuss the theoretical and epidemiological perspectives of NDIs in the context of extreme prematurity to guide communication with families and shared care decision-making.
cognition, developmental trajectories, extreme prematurity, life-course effects, neurodevelopment, neurodevelopmental impairments, neurodisability, outcomes, risk factors, shared care decision-making
1751-7222
18 - 27
Fernandes, Michelle
16d62e60-ae8e-455f-88d3-88e778253b4a
Hanna, Sean
9c75222b-db23-4785-8392-9d527370f788
Sharma, Alok
37f11b5d-3941-4a98-9083-1a3b49844916
Fernandes, Michelle
16d62e60-ae8e-455f-88d3-88e778253b4a
Hanna, Sean
9c75222b-db23-4785-8392-9d527370f788
Sharma, Alok
37f11b5d-3941-4a98-9083-1a3b49844916

Fernandes, Michelle, Hanna, Sean and Sharma, Alok (2022) Neurodevelopmental outcomes of extremely preterm infants: theoretical and epidemiological perspectives to guide shared-care decision-making. Paediatrics and Child Health, 32 (1), 18 - 27. (doi:10.1016/j.paed.2021.10.005).

Record type: Article

Abstract

Although births below 28 completed weeks' of gestation contribute to less than 1% of all preterm births globally, the impact of extreme prematurity (EPT) on neurodevelopmental outcomes across the life-course is disproportionately large. Higher rates and increased severity of neurodevelopmental impairments (NDIs) are reported among extremely preterm infants (EPIs). Cognitive skills, motor skills (manifesting as cerebral palsy) and vision are most commonly affected, with effects pervasive throughout school, adolescence and early adulthood. In addition, poorer academic outcomes and higher rates of psychiatric morbidity are seen among EPTs. Consistent improvements in EPI survival in recent years has not been matched with improvements in neurodevelopmental outcomes, especially for those born at less than 25 gestational weeks. However, over the last 20 years, several national and cross-national cohort studies have helped advance our understanding of extreme prematurity's developmental and life-course consequences. Here we provide an overview of the key findings from 13 multi-centre cohorts measuring neurodevelopmental outcomes and discuss the theoretical and epidemiological perspectives of NDIs in the context of extreme prematurity to guide communication with families and shared care decision-making.

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More information

e-pub ahead of print date: 8 December 2021
Published date: 7 January 2022
Additional Information: Publisher Copyright: © 2021 Elsevier Ltd
Keywords: cognition, developmental trajectories, extreme prematurity, life-course effects, neurodevelopment, neurodevelopmental impairments, neurodisability, outcomes, risk factors, shared care decision-making

Identifiers

Local EPrints ID: 457174
URI: http://eprints.soton.ac.uk/id/eprint/457174
ISSN: 1751-7222
PURE UUID: c2eeca82-3147-4cbc-bab0-9f53555b38c9
ORCID for Michelle Fernandes: ORCID iD orcid.org/0000-0002-0051-3389

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Date deposited: 25 May 2022 17:06
Last modified: 07 Jan 2023 05:01

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Contributors

Author: Michelle Fernandes ORCID iD
Author: Sean Hanna
Author: Alok Sharma

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