We’re sorry, something doesn't seem to be working properly.
Please try refreshing the page. If that doesn't work, please contact us so we can address the problem.
Cranial ultrasound screening in late preterm infants
© Fumagalli et al; licensee BioMed Central Ltd. 2014
Published: 9 October 2014
Late preterm births have enormously increased in the last decades and there is mounting evidence showing that infants born late preterm are less healthy than infants born at term  and they are more likely to develop neonatal morbidities (temperature instability, respiratory distress syndrome, excessive weight loss and dehydration requiring intravenous infusion, sepsis, hypoglycemia and jaundice requiring phototherapy) .
More recently, an increased neuromorbidity has been documented and long-term neurodevelopmental impairments (poor school performance, early intervention services, special education needs) have been reported in this population [3, 4]. The neuromorbidity of the late preterm infants has been attributed to both the potential detrimental neurological effects (extrinsic vulnerability) of the morbidities these babies experience in the neonatal period, and to the intrinsic brain vulnerability. Advances in neuroimaging techniques have highlighted a higher intrinsic vulnerability of the late preterm brain due to the structural and molecular immaturity of the developing brain at specific gestational ages [5, 6].
Therefore, late preterm infants have a risk to develop brain lesions which is lower than more premature babies but higher than term newborns and they can be affected by brain lesions common to both preterm and term infants . However, the incidence of brain abnormalities in this specific population has never been investigated as late preterm infants have long been considered a large and low-risk population.
Considering that most of the brain lesions are clinically subtle or silent during the neonatal period, a cranial ultrasound screening may play a role in: 1. detecting babies at risk of impaired neurodevelopment later in childhood and who may benefit from early intervention programs; 2. identifying the most significant perinatal risk factors associated with brain abnormalities in such a large low-risk population in order to target the potential need for cranial ultrasound at birth. Based on these assumptions we performed a cranial ultrasound screening project on late preterm infants. Our preliminary data (unpublished data) suggest that lower gestational age, within the late preterm period, and early neonatal morbidities, can provide an indication at birth to undergo a cranial ultrasound scan as they are associated with a higher risk to develop brain abnormalities. Late preterm infants represent a vulnerable population and investigation and follow-up program should be modulated according to the prenatal, perinatal and postnatal characteristics.
Follow-up studies are needed to correlate neonatal ultrasound findings with long-term neurobehavioral outcomes in late preterm infants.
- Shapiro-Mendoza CK, Lackritz EM: Epidemiology of late and moderate preterm birth. Semin Fetal Neonatal Med. 2012, 17 (3): 120-5. 10.1016/j.siny.2012.01.007.PubMed CentralView ArticlePubMedGoogle Scholar
- Wang ML, Dorer DJ, Fleming MP: Clinical outcomes of near-term infants. 2004, 114 (2): 372-6.Google Scholar
- Shah PE, Robbins N, Coelho RB: The paradox of prematurity: The behavioral vulnerability of late preterm infants and the cognitive susceptibility of very preterm infants at 36 months post-term. Infant Behav Dev. 2013, 36 (1): 50-62. 10.1016/j.infbeh.2012.11.003.PubMed CentralView ArticlePubMedGoogle Scholar
- Talge NM, Holzman C, Wang J: Late-preterm birth and its association with cognitive and socioemotional outcomes at 6 years of age. Pediatrics. 2010, 126 (6): 1124-31. 10.1542/peds.2010-1536.View ArticlePubMedGoogle Scholar
- Childs AM, Ramenghi LA, Evans DJ: MR features of developing periventricular white matter in preterm infants: evidence of glial cell migration. AJNR. 1998, 19 (5): 971-6.PubMedGoogle Scholar
- Judaš M, Sedmak G, Kostović I: The significance of the subplate for evolution and developmental plasticity of the human brain. Front Hum Neurosci. 2013, 7: 423-PubMed CentralPubMedGoogle Scholar
- Sannia A, Natalizia AR, Parodi A: Different gestational ages and changing vulnerability of the premature brain. J Matern Fetal Neonatal Med. 2013, [Epub ahead of print]Google Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.