| DEVELOPMENTAL
DISABILITIES AND EXTREMELY PRE-TERM BIRTH The UCP Research and Educational Foundation has reported previously on the evidence supporting the association of developmental brain injury (C.P.). With prematurity (less than 37 weeks of intrauterine life) and with low birth weight less than 5.3 lbs). Many studies supporting these observations use prematurity and low birth weight inter-changeably which they are not; also, they usually are retrospective studies using the careful review of previous hospital and clinical records as the basis of the study. There has been a clear need for a study of prematurity per se, following prospectively children from the time of birth in order to validate the conclusions drawn from previous evaluations The needed study has now been done with evaluation of a large enough group of subjects to make the results scientifically acceptable. Dr. Nicholas S. Wood and his associates have completed and reported on a prospective study of nervous system disability after extremely pre-term birth (25 or less weeks of intrauterine age). All surviving children who were born between 20-25 weeks of intrauterine life (gestational age) in the United Kingdom and Ireland from March through December 1995 were studied; Infants who are younger than 20 weeks gestational age are very rarely born alive or survive. All surviving children were evaluated at 30 months of age, their present age being adjusted to those of full-term infants. of the 308 survivors, this provided 283 children for study. Overall, 49% of the children evaluated had significant nervous system disabilities, including 23% who had a severe disability. Thus, it was concluded that neurological disability-particularly severe disability-is common in surviving infants born very prematurely. 75% fo the children with disabilities had cerebral palsy. The disabilities included impairment of motor function (movement); sensory acuity (vision, hearing), communication (speech) and/or mental abilities. The study confirms that extreme prematurity is an important risk factor for the occurrence of developmental brain disorders, particularly cerebral palsy. Comment: Also, in the August 16, 2000 issue of the Journal of the American Medical Association, Dr. Michael Kramer and his associates report that infants born at 32-36 weeks of gestational age were 6 times more likely to die within the first year of life; and those born at 34-36 weeks of gestational age were 3 times more likely to die in the first year of life than did full-term (40 weeks) infants. The usual causes of death were infection, problems with breathing, various birth defects and developmental disorders and sudden infant death syndrome. All of the above are the reasons for the Foundation’s targeted,
high priority research effort to learn how to prevent prematurity, how
to protect the developing brain from threats during the infant’s
prenatal and postnatal period, and how to support the normal growth and
development of the premature infant’s brain. |