Thanks to the medical advances premature infants are increasingly able to survive. With every day neuroscientists are developing the increasingly sophisticated picture of premature infants’ brains that could help to inform medical decisions and treatments. Some long-term studies show that premature children face a higher than previously thought risk of developing cognitive or behavioral problems. According to some studies as many as half of premature children will have some cognitive of behavioral problem. Researchers are starting to ask why this happens be, whether it can be avoided and what is the best way to provide educational support for the affected children.
Just a few studies have so far followed up the long-term development of premature babies. Long term studies are time-consuming and expensive because they require to track children with sophisticated cognitive and behavioral tests over many years.
One of the first studies to show the extent of developmental problems was so-called EPIPAGE study which looked at a cohort of all live births between 22 and 32 weeks of gestation from 9 regions of France in 1997 and a reference group of 664 full-term babies. The study showed that up to half of the premature babies who survived to five years of age had some sort of neurodevelopmental problem.
Developmental psychologist Dieter Wolke led an unusual study of hundreds of children born between 26 and 31 weeks of gestation in Bavaria in the mid-1980s. He assessed them at six years old, and again at 26 years. Last year, he reported that most of those who had cognitive problems as children still had them as adults.
Scientists suspect that when the brain is forced to carry out the crucial part of its development while the child is in the outside world instead of a warm, watery womb, it receives inappropriate signals from the environment that affect how the neurons are linked into networks. The premature brain gets subjected to quite different sensory inputs — like visual stimulation and gravity effects — which it is not supposed to be subject to. Some of these unnatural sensory signals are inevitably provided by the intensive medical procedures that keep premature babies alive.
Pioneering brain-scanning studies support the idea that altered networks play a part in cognitive problems. Petra Hüppi, a neonatologist and developmental pediatrician at the University of Geneva in Switzerland, is conducting a clinical study of erythropoietin, or EPO, a drug that stimulates the production of red blood cells. It is already a standard treatment to aid oxygenation of internal organs — not to mention being a favourite among endurance-sport cheats — and it is also thought to protect and support neurons.