By Chiara Nosarti, Robin M. Murray, Maureen Hack
The enhanced survival of very preterm and intensely low beginning weight babies in contemporary a long time has been linked to a rise within the occurrence of actual and neurodevelopmental difficulties. consciousness is more and more being desirous about the standard of lifetime of survivors, who're at better possibility of mind harm and consequent neurological problems, and neuropsychological and behavioural impairments. during this quantity, top specialists current a entire and updated point of view on study in quite a few points of the long term effects of very preterm delivery. in addition to extending present wisdom of the neurodevelopmental sequelae following very preterm start, a shared objective of this burgeoning physique of analysis is to spot the mechanisms underlying adaptations in final result, and hence know subgroups of kids who're at elevated danger of neurodevelopmental difficulties, for whom applicable intervention recommendations might be devised. Pediatricians, neurologists, psychiatrists and psychologists will all locate this to be crucial examining.
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Additional resources for Neurodevelopmental Outcomes of Preterm Birth: From Childhood to Adult Life
Sample text
Sick infants who are receiving mechanical ventilation may show a strong correlation between second-tosecond changes in arterial blood pressure and indices of cerebral oxygenation. This is thought to indicate the loss of normal cerebral vascular control mechanisms, and the presence of a pressure-passive cerebral circulation. In this clinical context it is likely that rapid fluctuations in arterial blood pressure will be transmitted directly to the cerebral vasculature, and this may result in the rupture of vulnerable vessels within the germinal matrix.
However, in the late 1970s it became possible to image the infant brain during life, with the introduction of computed tomography (CT) X-ray scanning in a few major centers. In 1979 imaging of the infant brain using real-time ultrasound through the anterior fontanel was described simultaneously by the UCHL group and by Richard Cooke [1]. It became apparent that there was a disturbingly high incidence of IVH in very preterm survivors, with 30–40% of the smallest babies affected. In 1979 Ann Stewart and Osmund Reynolds commenced a prospective follow-up study of very preterm infants at UCHL designed to relate cranial ultrasound appearances in the neonatal period with long-term neurological and developmental outcome [12,13].
Diffusionweighted imaging of the brain in preterm infants with focal and diffuse white matter abnormality. Pediatrics 2003; 112(1 Pt 1): 1–7. Hüppi PS, Warfield S, Kikinis R, et al. Quantitative magnetic resonance imaging of brain development in premature and mature newborns. Ann Neurol 1998; 43(2): 224–35. Hüppi PS, Murphy B, Maier SE, et al. Microstructural brain development after perinatal cerebral white matter injury assessed by diffusion tensor magnetic resonance imaging. Pediatrics 2001; 107(3): 455–60.