Johnson Samantha, Marlow Neil
Department of Health Sciences, University of Leicester, Leicester, UK.
Institute for Women's Health, University College London, London, UK.
Arch Dis Child. 2017 Jan;102(1):97-102. doi: 10.1136/archdischild-2015-309581. Epub 2016 Aug 10.
There is no question that birth at extremely low gestational ages presents a significant threat to an infant's survival, health and development. Growing evidence suggests that gestational age may be conceptualised as a continuum in which births before 28 weeks of gestation (extremely preterm: EP) represent the severe end of a spectrum of health and developmental adversity. Although comprising just 1%-2% of all births, EP deliveries pose the greatest challenge to neonatal medicine and to health, education and social services for the provision of ongoing support for survivors with additional needs. Studying the outcomes of these infants remains critical for evaluating and enhancing clinical care, planning long-term support and for advancing our understanding of the life-course consequences of immaturity at birth. Here we review literature relating to early and long-term neurodevelopmental, cognitive, behavioural and educational outcomes following EP birth focusing on key themes and considering implications for intervention.
毫无疑问,极低孕周出生对婴儿的生存、健康和发育构成重大威胁。越来越多的证据表明,孕周可被视为一个连续体,其中妊娠28周之前出生的婴儿(极早产儿:EP)代表了健康和发育逆境谱的严重一端。尽管极早产儿仅占所有出生婴儿的1%-2%,但其分娩对新生儿医学以及为有额外需求的幸存者提供持续支持的健康、教育和社会服务构成了最大挑战。研究这些婴儿的结局对于评估和改善临床护理、规划长期支持以及增进我们对出生时不成熟的生命历程后果的理解仍然至关重要。在此,我们回顾了与极早产儿出生后的早期和长期神经发育、认知、行为和教育结局相关的文献,重点关注关键主题并考虑干预的影响。