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Chapter 30 - Reducing Neurologic Morbidity from Preterm Birth through Administering Therapy Prior to Delivery

from Preterm Birth of the Singleton and Multiple Pregnancy

Published online by Cambridge University Press:  21 October 2019

Mark D. Kilby
Affiliation:
University of Birmingham
Anthony Johnson
Affiliation:
University of Texas Medical School at Houston
Dick Oepkes
Affiliation:
Leids Universitair Medisch Centrum
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Summary

Preterm birth before 37 weeks gestation affects 10–15% of all births, with nearly 15 million babies born preterm every year [1]. Prematurity is the leading cause of neonatal mortality, accounting for in excess of 75% of perinatal deaths [2]. Infants born preterm are at high risk of both short- and long-term neurological morbidity, including developmental delay, cognitive problems, hearing loss, visual impairment, behavioral problems, and cerebral palsy [3]. The impact of these sequelae is high, with 27.9% (IQR [interquartile range] 18.6–46.6) of preterm neonates suffering from at least one, and 8.1% (IQR 3.7–10.2) suffering multiple morbidities [3]. Despite improvements in perinatal care the incidence of preterm birth has changed little in decades. In contrast, improvements in neonatal care mean nearly 90% of all babies born less than 28 weeks in high-income countries survive, including babies born as early as 23 weeks’ gestation [1]. Despite this improvement in survival, babies born at extreme preterm gestations are at the highest risk of neurological injury, with rates of cerebral palsy and severe disability in these survivors remaining static [4].

Type
Chapter
Information
Fetal Therapy
Scientific Basis and Critical Appraisal of Clinical Benefits
, pp. 333 - 343
Publisher: Cambridge University Press
Print publication year: 2020

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