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 Pregnancy normally lasts about 40 weeks, and babies born after 37
weeks are considered full term. The study focused on extremely
preterm infants, delivered at 23 to 25 weeks gestation.
In the weeks immediately after birth, these early arrivals often
have difficulty breathing and digesting food. They can also
encounter longer-term challenges such as impaired vision, hearing,
and cognitive skills as well as social and behavioral problems.
“Children born extremely preterm at 23 to 25 weeks gestation face an
increased risk of chronic health problems such as neurodevelopmental
handicap (mostly mild or moderate), asthma, and behavioral
difficulties,” said study co-author Dr. Aijaz Farooqi, a researcher
at the University Hospital of Umea in Sweden.
“At school age, many extremely preterm children whose general
intelligence is normal or in the lower normal range have motor
impairments, behavioral problems, social problems and academic
underachievement,” Farooqi added by email.
Farooqi’s team studied 134 youngsters ages 10 to 15 who were born
extremely preterm, plus 103 children who were full-term infants but
otherwise similar.
Compared to the full-term group, adolescents in the preemie group
were 15 times more likely to have severe physical or mental
impairments and more than five times as likely to require more
medical or educational services than children typically need, the
study found.
Overall, 64 percent of the preemies in the study had functional
limitations, compared with 6 percent of the full-term teens,
researchers report in Pediatrics.
This included mental or emotional developmental delays as well as an
inability to play and socialize.
In addition, 60 percent of the adolescents who were preterm infants
needed special equipment or assistance to complete daily tasks like
walking, feeding, dressing and using the bathroom, compared to just
29 percent of the teens who were born full-term.
Roughly 64 percent of the teens born preterm needed routine care
from a physician or specialist for a chronic health problems or
special services like physical or occupational therapy, nursing care
or special school arrangements. That was true for 25 percent of
other kids in the study.
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Even though the study didn’t examine what factors might cause
problems for extremely preterm babies who survive to adolescence,
disruptions in brain and central nervous system development may be
part of the problem, Farooqi said.
The study was small and it wasn’t designed to see how birth timing
influences health in adolescence, however.
Complications that are common in extremely preterm infants, such as
central nervous system injuries, lung disease, eye problems and
infections, “have been shown to be related to many of the chronic
health problems” Farooqi noted.
Still, there are things parents can do for preemies that may make a
difference later on, said Dr. Jill Zwicker, a researcher at the
University of British Columbia in Canada who wasn’t involved in the
study.
“When deemed safe to do so, parents can help their babies by holding
them skin-to-skin while in the nursery, which is mutually beneficial
for parents and babies,” Zwicker said by email.
“Throughout childhood, parents can support their child's development
by providing enriching opportunities for learning - reading to them,
providing opportunities to move and play, exploring the environment,
engaging with other children - and so on,” Zwicker added. “Early
developmental intervention, such as occupational and physical
therapy, can also improve outcomes.”
SOURCE: http://bit.ly/2jgIUfK Pediatrics, online January 20, 2017.
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