1 Department of Developmental and Social Psychology (DPSS), University of Padua, Padua, Italy ; 2 Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Transl Pediatr. 2015 Jul;4(3):214-8. doi: 10.3978/j.issn.2224-4336.2015.06.02.
Many survivors of preterm birth experience neurodevelopmental disabilities, such as cerebral palsy, visual and hearing problems. However, even in the absence of major neurological complications, premature babies show significant neuropsychological and behavioural deficits during childhood and beyond. While the clinical tools routinely used to assess neurocognitive development in those infants have been useful in detecting major clinical complications in early infancy, they have not been equally sensitive in identifying subtle cognitive impairments emerging during childhood. These methodological concerns become even more relevant when considering the case of late preterm children (born between 34 and 36 gestational weeks). Although these children have been traditionally considered as having similar risks for developmental problems as neonates born at term, a recent line of research has provided growing evidence that even late preterm children display altered structural and functional brain maturation, with potential life-long implications for neurocognitive functioning. A recent study by Heinonen put forward the hypothesis that environmental factors, in this case educational attainment, could moderate the association between late preterm birth (LPT) and neuropsychological impairments commonly associated with aging. In this paper we bring together clinical literature and recent neuroimaging evidence in order to provide two different but complementary approaches for a better understanding of the "nature-nurture" interplay underlying the lifespan neurocognitive development of preterm babies.
许多早产儿幸存者会经历神经发育障碍，例如脑瘫、视力和听力问题。然而，即使没有重大的神经并发症，早产儿在儿童期及以后仍会表现出明显的神经心理和行为缺陷。虽然临床上常用的评估这些婴儿神经认知发育的工具在检测婴儿早期的重大临床并发症方面非常有用，但它们在识别儿童期出现的细微认知障碍方面并不敏感。当考虑晚期早产儿（出生于 34 至 36 孕周之间）的情况时，这些方法上的担忧就更加重要了。尽管这些儿童传统上被认为与足月出生的新生儿具有相似的发育问题风险，但最近的一系列研究提供了越来越多的证据表明，即使是晚期早产儿也会表现出大脑结构和功能成熟的改变，这可能对神经认知功能产生终身影响。Heinonen 最近的一项研究提出了这样一种假设，即环境因素（在这种情况下是教育程度）可以调节晚期早产儿出生（LPT）与与衰老相关的常见神经心理障碍之间的关联。在本文中，我们汇集了临床文献和最近的神经影像学证据，以提供两种不同但互补的方法，以便更好地理解早产儿整个生命周期神经认知发育的“先天-后天”相互作用。
