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The case of late preterm birth: sliding forwards the critical window for cognitive outcome risk

机译:早产的情况:向前滑动认知结果风险的关键窗口

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摘要

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.
机译:许多早产幸存者会经历神经发育障碍,例如脑瘫,视力和听力障碍。然而,即使没有重大的神经系统并发症,早产儿在儿童期及以后仍表现出明显的神经心理和行为缺陷。尽管常规用于评估这些婴儿神经认知发育的临床工具已可用于检测婴儿早期的主要临床并发症,但它们在识别儿童期出现的细微认知障碍方面同样不敏感。当考虑晚期早产儿(出生在妊娠34至36周之间)时,这些方法上的问题就变得更加重要。尽管传统上认为这些孩子与足月新生儿有发展问题的风险,但最近的研究表明,即使早产的早产儿也表现出大脑结构和功能的改变,对神经认知具有终生影响运作。 Heinonen最近的一项研究提出了这样的假设:环境因素(在这种情况下是受教育程度)可以缓解早产(LPT)与通常与衰老相关的神经心理障碍之间的关联。在本文中,我们将临床文献和最新的神经影像学证据结合在一起,以提供两种不同但互补的方法,以更好地理解早产儿终生神经认知发展的“自然-养育”相互作用。

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