Challenges of Preterm Birth
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- Created by: Yasmetron
- Created on: 04-02-23 20:07
What Classes as:
Moderate/Late Preterm
Very Preterm
Extremely Preterm
Moderate/Late Preterm
Very Preterm
Extremely Preterm
Moderate/Late Preterm = 32-36 weeks
Very Preterm = 28-31 weeks
Extremely Preterm <28
Very Preterm = 28-31 weeks
Extremely Preterm <28
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What are the three types of preterm babies?
Spontaneous
Preterm premature ruptures of membranes (PPROM)
Delivery for maternal and foetal complications (caesarean delivery or labour induction)
Preterm premature ruptures of membranes (PPROM)
Delivery for maternal and foetal complications (caesarean delivery or labour induction)
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What are maternal risk factors?
• Intrauterine Infections (est. 25 – 40%)
• Low BMI or High BMI
• Previous preterm birth
• Advanced maternal age
• Short interval between pregnancies
• Multiple gestations, 60% twins
• Low BMI or High BMI
• Previous preterm birth
• Advanced maternal age
• Short interval between pregnancies
• Multiple gestations, 60% twins
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What are the psychological and social stresses?
- depression
- alcohol consumption
- smoking
- poverty
- inadequate prenatal care
- limited education
- young maternal age
- alcohol consumption
- smoking
- poverty
- inadequate prenatal care
- limited education
- young maternal age
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What did Orr et al. (2002) find?
Recruited 1399 pregnant women
Depression Questionnaire at prenatal clinic 117 spontaneous preterm delivery
Preterm birth in 12.7% of those with elevated depression (upper 10% of scores) c.f. 8.0% in low depression
Depression Questionnaire at prenatal clinic 117 spontaneous preterm delivery
Preterm birth in 12.7% of those with elevated depression (upper 10% of scores) c.f. 8.0% in low depression
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What are the impacts if you are African-American?
double the risk of preterm outcome
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What are some of the complications for preterm babies?
Brain- bleeding into ventricles, intraventricular haemorrhage (IVH) leads to physical disability. Severe physical disability relatively uncommon (~2%) but may have milder cerebral palsy and less developed motor skills. Also, cognitive difficulties. Higher
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What are the neurocongitive functions of a severely disabled child at 6 years old?
cerebral palsy, non-ambulatory, IQ > 3 SD below mean, hearing loss, blind
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What are the neurodevelopment problems?
Gestational age at birth
Brain-injury
growth restriction
Low SES
Brain-injury
growth restriction
Low SES
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What is the impact on brain development?
Reduced cortical gyrification
Alterations in network connectivity in children and adults
Reduced cortical complexity in preterms
Differences in trajectory of cerebral development from late-childhood to adolescence
Persists into adulthood linked to reduc
Alterations in network connectivity in children and adults
Reduced cortical complexity in preterms
Differences in trajectory of cerebral development from late-childhood to adolescence
Persists into adulthood linked to reduc
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What are the implications for being in NICU?
NICU environment may influence brain development during a sensitive period for brain growth
Excess light, sound, painful procedures
Positive sensory experiences have long-term implications for learning, memory, emotional development
Excess light, sound, painful procedures
Positive sensory experiences have long-term implications for learning, memory, emotional development
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What did Birtles et al. (2007) study and find?
There is a three week delay in onset of responses in preterm infants in the directional reversal of the dorsal stream. this could possibly impact visuomotor skills
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What is the impact on fixation shifts?
Preterm infants are slower to disengage i.e. “sticky fixation” compared to full-term infants in competition condition
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How does it impact the Psychomotor Developmental Index?
Children born PT had poorer PDI than FT Effect size d = -.88
PDI scores of PT with perinatal complications were much lower than FT Effect size d = -1.30
PDI scores of PT with perinatal complications were much lower than FT Effect size d = -1.30
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What is the relationship between preterm and IQ
IQ in preterm is significantly lower than term born
Differences in IQ remain across lifespan
Differences in IQ remain across lifespan
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How is processing speed impacted?
Preterm individuals have slower processing speed than full-term. (Anderson et al. 2003) Std scores: VPT = 98.8; FT = 105.4 (p < .001)
Differences in primary, secondary school and adulthood (Allotey et al. 2018)
Differences in primary, secondary school and adulthood (Allotey et al. 2018)
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How is visuospatial skills impacted?
Preterm children have poorer visuospatial skills than full-term (8 years; Anderson et al. 2003) PT (N = 257); FT (N = 219)
VPT = 97.6; FT = 105.4 (p < .001)
VPT = 97.6; FT = 105.4 (p < .001)
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How is cognitive development impacted?
Lower IQ in preterms, persists into adulthood
Lower WM, processing speed and visuospatial skills
Increased risk of SEN as GA decreases
Lower WM, processing speed and visuospatial skills
Increased risk of SEN as GA decreases
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How is motor development impacted?
Poorer fine and gross motor skills
Some catch up in early childhood but differences remain in later childhood
High risk for Developmental Coordination Disorder
No improvement in motor or cognitive skills with improved neonatal care since 1990s
Some catch up in early childhood but differences remain in later childhood
High risk for Developmental Coordination Disorder
No improvement in motor or cognitive skills with improved neonatal care since 1990s
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How is school performance impacted?
Not achieving expected level
of performance in reading, writing and maths
Risk of poor performance increased with
prematurity
Greater impairment in maths compared to other subjects (Allotey et al. 2018; Johnson et al. 2016)
of performance in reading, writing and maths
Risk of poor performance increased with
prematurity
Greater impairment in maths compared to other subjects (Allotey et al. 2018; Johnson et al. 2016)
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Why do preterm children find maths hard?
Poorer working memory (WM) and visuospatial skills (VSS)
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How does being born preterm impact mental health?
- Preterm birth a risk factor for: Attention deficit/hyperactivity disorder (ADHD), emotional disorders, and autistic spectrum disorders (ASD)
- Preterm behavioural phenotype with increased risk for inattention, anxiety and social disorders
- Preterms are
- Preterm behavioural phenotype with increased risk for inattention, anxiety and social disorders
- Preterms are
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Do preterm children internalise or externalise problems in comparison to full term?
internalising
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How do emotional difficulties change in adulthood?
Emotional disorders reduce in adulthood
Australian Cohort (215 EPT and 157 FT at age 18 years) similar levels of mood and anxiety disorders but fewer antisocial personality traits.
Australian Cohort (215 EPT and 157 FT at age 18 years) similar levels of mood and anxiety disorders but fewer antisocial personality traits.
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How is adversity impacted?
Preterms particularly sensitive to psychosocial adversity
Preterms have increased likelihood of exposure to adversity (Children born VPT/EPT 3x more likely to be chronically bullied)
Preterms have increased likelihood of exposure to adversity (Children born VPT/EPT 3x more likely to be chronically bullied)
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What is the relationship between preterm and autism?
Severe early deprivation and impaired social stimulation may lead to similar brain alterations and impact on social, emotional and behavioural outcomes
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Other cards in this set
Card 2
Front
What are the three types of preterm babies?
Back
Spontaneous
Preterm premature ruptures of membranes (PPROM)
Delivery for maternal and foetal complications (caesarean delivery or labour induction)
Preterm premature ruptures of membranes (PPROM)
Delivery for maternal and foetal complications (caesarean delivery or labour induction)
Card 3
Front
What are maternal risk factors?
Back
Card 4
Front
What are the psychological and social stresses?
Back
Card 5
Front
What did Orr et al. (2002) find?
Back
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