Promoting sound development of preterm infants in the name of developmental neuroscience: Beyond advanced life support and neuroprotection

Despite the increased survival opportunities for extremely preterm infants, their long-term cognitive outcomes remain poor, with increased incidence of cognitive impairments in childhood and reduced opportunities to attend higher education in young adulthood compared to their term-born peers. Given...

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Main Authors: Osuke Iwata, Sachiko Iwata, Yung-Chieh Lin, Shin Kato, Yuko Mizutani, Tadashi Hisano, Masahiro Kinoshita, Satoko Fukaya, Koya Kawase, Shinji Saitoh
Format: Article
Language:English
Published: Elsevier 2021-02-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957220301972
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author Osuke Iwata
Sachiko Iwata
Yung-Chieh Lin
Shin Kato
Yuko Mizutani
Tadashi Hisano
Masahiro Kinoshita
Satoko Fukaya
Koya Kawase
Shinji Saitoh
author_facet Osuke Iwata
Sachiko Iwata
Yung-Chieh Lin
Shin Kato
Yuko Mizutani
Tadashi Hisano
Masahiro Kinoshita
Satoko Fukaya
Koya Kawase
Shinji Saitoh
author_sort Osuke Iwata
collection DOAJ
description Despite the increased survival opportunities for extremely preterm infants, their long-term cognitive outcomes remain poor, with increased incidence of cognitive impairments in childhood and reduced opportunities to attend higher education in young adulthood compared to their term-born peers. Given that a considerable fraction of preterm infants develop cognitive impairments even without apparent sentinel events at birth and cerebral lesions on MRI assessed at term equivalent age, future strategies to improve the outcome may need to address cerebral dysfunction, which cannot be explained by the classical understanding of the injury cascade triggered by hypoxia-ischaemia around birth. Developmental care has been proposed to minimize neurodevelopmental impairments related to preterm birth. However, considerable modes of cares, environmental settings and procedures provided by the developmental care of current style appear to offer little benefit to the sound development of infants. Although it is obvious that advanced life support and neuroprotective treatments fall far short in compensating for the burden of preterm birth, researchers need to make further effort to fill the knowledge gap in the cerebral function of foetuses and newborn infants before establishing evidence-based developmental care. Clinicians need to develop an ability to translate the findings from basic and translational studies incorporating their potential biases and limitations. Care for newborn infants needs to be reassessed, including but not limited to developmental care, in the context that any sensory input and motor reaction of preterm infants may ultimately affect their cognitive functioning.
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spelling doaj-art-3e47bf44582a42779de59bf85d7f1c672025-08-20T03:03:52ZengElsevierPediatrics and Neonatology1875-95722021-02-0162S10S1510.1016/j.pedneo.2020.11.006Promoting sound development of preterm infants in the name of developmental neuroscience: Beyond advanced life support and neuroprotectionOsuke Iwata0Sachiko Iwata1Yung-Chieh Lin2Shin Kato3Yuko Mizutani4Tadashi Hisano5Masahiro Kinoshita6Satoko Fukaya7Koya Kawase8Shinji Saitoh9Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan; Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, 830-0011, Japan; Corresponding author. Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan.Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, JapanDepartment of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan; Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng-Kung University, Tainan, 70403, TaiwanDepartment of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, JapanDepartment of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, JapanDepartment of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, JapanDepartment of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng-Kung University, Tainan, 70403, TaiwanDepartment of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, JapanDepartment of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, JapanDepartment of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, JapanDespite the increased survival opportunities for extremely preterm infants, their long-term cognitive outcomes remain poor, with increased incidence of cognitive impairments in childhood and reduced opportunities to attend higher education in young adulthood compared to their term-born peers. Given that a considerable fraction of preterm infants develop cognitive impairments even without apparent sentinel events at birth and cerebral lesions on MRI assessed at term equivalent age, future strategies to improve the outcome may need to address cerebral dysfunction, which cannot be explained by the classical understanding of the injury cascade triggered by hypoxia-ischaemia around birth. Developmental care has been proposed to minimize neurodevelopmental impairments related to preterm birth. However, considerable modes of cares, environmental settings and procedures provided by the developmental care of current style appear to offer little benefit to the sound development of infants. Although it is obvious that advanced life support and neuroprotective treatments fall far short in compensating for the burden of preterm birth, researchers need to make further effort to fill the knowledge gap in the cerebral function of foetuses and newborn infants before establishing evidence-based developmental care. Clinicians need to develop an ability to translate the findings from basic and translational studies incorporating their potential biases and limitations. Care for newborn infants needs to be reassessed, including but not limited to developmental care, in the context that any sensory input and motor reaction of preterm infants may ultimately affect their cognitive functioning.http://www.sciencedirect.com/science/article/pii/S1875957220301972Cognitive developmentDevelopmental careDiurnal rhythmPreterm infantsSensory input
spellingShingle Osuke Iwata
Sachiko Iwata
Yung-Chieh Lin
Shin Kato
Yuko Mizutani
Tadashi Hisano
Masahiro Kinoshita
Satoko Fukaya
Koya Kawase
Shinji Saitoh
Promoting sound development of preterm infants in the name of developmental neuroscience: Beyond advanced life support and neuroprotection
Pediatrics and Neonatology
Cognitive development
Developmental care
Diurnal rhythm
Preterm infants
Sensory input
title Promoting sound development of preterm infants in the name of developmental neuroscience: Beyond advanced life support and neuroprotection
title_full Promoting sound development of preterm infants in the name of developmental neuroscience: Beyond advanced life support and neuroprotection
title_fullStr Promoting sound development of preterm infants in the name of developmental neuroscience: Beyond advanced life support and neuroprotection
title_full_unstemmed Promoting sound development of preterm infants in the name of developmental neuroscience: Beyond advanced life support and neuroprotection
title_short Promoting sound development of preterm infants in the name of developmental neuroscience: Beyond advanced life support and neuroprotection
title_sort promoting sound development of preterm infants in the name of developmental neuroscience beyond advanced life support and neuroprotection
topic Cognitive development
Developmental care
Diurnal rhythm
Preterm infants
Sensory input
url http://www.sciencedirect.com/science/article/pii/S1875957220301972
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