Besides the question of whether the child will survive, parents are confronted with the question on how their child’s development will be. Preterm infants are at risk for problems in a variety of areas, depending on the individual situation of each baby. The later the infant is born, the lower the risk of subsequent problems. However, even a preterm baby of 34 weeks gestation may have difficulties later, whereas very small preterm babies may, in many cases, develop completely normal.
Particularly at risk are preterm babies who experience complications like cerebral hemorrhage, brain damage, severe infection or a chronic lung disease. But here again, individual predictions would be extremely difficult as the consequences of these complications differ from child to child. Each has its own unpredictable preterm history. The quality of family environments and learning experiences that parents provide to their children may help many children to compensate initial risks and developmental delays.
Preterm babies born at 30 weeks gestation or with 1,500 g birth weight have very good chances to develop completely normally physically and mentally, provided that no further complications occur after birth.
10 – 25% of preterm infants with a birth weight of 1,000-1,500 g and 28-30 weeks gestation as well as 20 – 30% of babies born extremely prematurely, i.e. with a birth weight of under 1,000 g or less than 28 weeks gestation may show developmental disorders requiring treatment. These may imply: movement disorders up to spastic cerebral palsy, low cognitive ability, seizures, blindness, deafness and disorders of mental development.
About one third of the very preterm birth infants show behavioral problems such as a lighter irritability, attention deficits and problems in social behavior e.g. when in contact with peers or interacting with their parents.
The disturbances of cognitive development and behavior may cause problems at school: According to data from the southern Bavarian development study and a study published in the Netherlands, 20% of very preterm birth infants visit schools for children with learning difficulties, 25% attend a class not appropriate to their age, and 15% receive special education in normal classes.
It is important, however, that the care of this child patient group starts at an early stage to prevent the development of disabilities. Deficits have to be recognized and then treated accordingly. To recognize and understand the child’s needs, education and good instruction of parents and professionals is essential. Parents can receive help at their national parents’ organization or even at the local after-care centers.
Possible problems that may occur after a preterm birth:
- Developmental delay
- ROP / retinal detachment
- Physical disabilities such as cerebral palsy
- Social skills deficits or integration deficits
- Internal or external organ disorders (intestine, heart, lungs / BPD / asthma or hearing, seeing or speaking problems)
- Mental retardation
- Learning disability or some inefficiencies (attention deficit ADHD, dyscalculia, dyslexia)
- Binding and interaction disorder
- Feeding problems and failure to thrive