Prematurity and Neurological Sequelae

M. Wahed
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Abstract

Any birth that takes place three weeks or more before the baby’s due date is a premature birth. Prematurity is a public health problem worldwide. Every year, 15 million infants are born premature, accounting for a prevalence of 11% in 84 surveyed countries. Premature births alone account for a quarter of all neonatal deaths. Survivors of premature births have high rates of postnatal morbidities. With the development technologies and medical procedures, the morbidities are increasing due to improving survival of borderline viable cases. The prevalence of cerebral palsy, intellectual and cognitive dysfunction, retinopathy, hearing loss, epilepsy, ADHD and autistic disorder are more in babies born preterm. The risk of cerebral palsy is 8- 10 times higher in preterm infants and nearly 30 times higher in infants born <32 weeks. Children born preterm have an average 12.9 IQ points lower than term born controls and these children face difficulty in making communication, executive functioning and cognition. ADHD and autism spectrum disorders are frequently diagnosed (OR 3.3) in children born preterm. ROP associated blindness is 10% in high income countries and 40% in middle and low income countries. As many as 10% children born preterm have hearing loss and 35% suffer from different types of epilepsy. Adequate antenatal check-up and immediate postnatal care are key issues to reduce or prevent neurological sequelae in survivors of premature birth. J Medicine 2023; Vol. 34, No. 2(1) Supplement: 212            
早产和神经后遗症
任何在预产期前三周或更早出生的婴儿都是早产。早产是一个全球性的公共卫生问题。每年有1500万婴儿早产,在84个接受调查的国家中占11%。仅早产就占所有新生儿死亡的四分之一。早产幸存者的产后发病率很高。随着技术和医疗手段的发展,边缘存活病例的存活率不断提高,发病率也在不断上升。脑瘫、智力和认知功能障碍、视网膜病变、听力丧失、癫痫、多动症和自闭症的患病率在早产婴儿中更高。早产儿患脑瘫的风险是早产儿的8- 10倍,小于32周的婴儿患脑瘫的风险高出近30倍。早产儿童的平均智商比足月出生的对照组低12.9分,这些儿童在沟通、执行功能和认知方面面临困难。ADHD和自闭症谱系障碍经常在早产儿童中被诊断(OR 3.3)。与ROP相关的失明在高收入国家为10%,在中低收入国家为40%。多达10%的早产儿童患有听力损失,35%患有不同类型的癫痫。充分的产前检查和及时的产后护理是减少或预防早产幸存者神经系统后遗症的关键问题。中华医学杂志2023;第34卷,第2(1)号补编:212
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