Preterm birth is associated with a wide range of common problems affecting multiple organ systems and developmental domains. Neurologically, children born preterm are at increased risk of cerebral palsy, motor function problems including developmental coordination disorder, and learning disabilities, with severity and prevalence increasing as gestational age decreases. Key risk factors include severe brain lesions such as grade 3 or 4 intraventricular haemorrhage and cystic periventricular leukomalacia, neonatal sepsis, and bronchopulmonary dysplasia requiring prolonged mechanical ventilation 1.
Neurodevelopmental impairments also encompass executive function deficits, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, and emotional and behavioural problems, particularly internalising behaviours and passivity. These risks are heightened in children born before 28 to 33 weeks’ gestation and are influenced by factors such as male sex, major brain lesions, and socio-economic disadvantages 1.
Speech, language, and communication disorders are common, especially in those with severe intraventricular haemorrhage or periventricular leukomalacia 1. Feeding difficulties related to oro-motor dysfunction may persist up to at least 6 years of age in extremely preterm children 1. Sleep problems, including sleep apnoea, are also more prevalent in this population 1.
Visual and hearing impairments are more frequent with decreasing gestational age, with retinopathy of prematurity requiring treatment and neonatal sepsis being significant risk factors 1.
From a broader neonatal perspective, preterm birth complications include respiratory distress syndrome, infections, and difficulties related to immature organ systems, which contribute to morbidity and mortality in the neonatal period (Ward and Beachy, 2003). These early complications can have long-term consequences on growth and neurodevelopment [1, (Ward and Beachy, 2003)].
Key References
- NG72 - Developmental follow-up of children and young people born preterm
- NG25 - Preterm labour and birth
- Terbutaline sulfate SmPC
- CKS - Urinary tract infection (lower) - women
- Buprenorphine SmPC
- Oxycodone hydrochloride SmPC
- Dihydrocodeine tartrate SmPC
- Co-codamol SmPC
- Alfentanil SmPC
- Codeine phosphate SmPC
- CKS - Hypertension in pregnancy
- (Ward and Beachy, 2003): Neonatal complications following preterm birth.