Promoting sound development of preterm infants in the name of developmental neuroscience: Beyond advanced life support and neuroprotection

Pediatrics and Neonatology

卷:62

Yung-Chieh Lin¹  Sachiko Iwata²  Tadashi Hisano³  Satoko Fukaya⁴  Koya Kawase⁴  Shin Kato⁴  Masahiro Kinoshita⁴  Yuko Mizutani⁴  Osuke Iwata⁴  Shinji Saitoh⁵ 

[1] Corresponding author. Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan.;

[2] Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, 830-0011, Japan;

[3] Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng-Kung University, Tainan, 70403, Taiwan;

[4] Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan;

关键词: Cognitive development;    Developmental care;    Diurnal rhythm;    Preterm infants;    Sensory input;   

DOI  :  

来源: DOAJ

【 摘 要 】

Despite the increased survival opportunities for extremely preterm infants, their long-term cognitive outcomes remain poor, with increased incidence of cognitive impairments in childhood and reduced opportunities to attend higher education in young adulthood compared to their term-born peers. Given that a considerable fraction of preterm infants develop cognitive impairments even without apparent sentinel events at birth and cerebral lesions on MRI assessed at term equivalent age, future strategies to improve the outcome may need to address cerebral dysfunction, which cannot be explained by the classical understanding of the injury cascade triggered by hypoxia-ischaemia around birth. Developmental care has been proposed to minimize neurodevelopmental impairments related to preterm birth. However, considerable modes of cares, environmental settings and procedures provided by the developmental care of current style appear to offer little benefit to the sound development of infants. Although it is obvious that advanced life support and neuroprotective treatments fall far short in compensating for the burden of preterm birth, researchers need to make further effort to fill the knowledge gap in the cerebral function of foetuses and newborn infants before establishing evidence-based developmental care. Clinicians need to develop an ability to translate the findings from basic and translational studies incorporating their potential biases and limitations. Care for newborn infants needs to be reassessed, including but not limited to developmental care, in the context that any sensory input and motor reaction of preterm infants may ultimately affect their cognitive functioning.

【 授权许可】

Unknown