Neurodevelopmental Outcomes of Preterm Birth
By Toshani Kapoor
According to the Centers for Disease Control and Prevention, about one in ten babies in the United States are born preterm. This means that in almost every classroom you could walk into, there may be a student who was born preterm. While the majority of these children grow up to be healthy, preterm birth, depending on how early it was, can affect how the brain develops, sometimes leading to disorders and learning challenges.
The third trimester, which covers weeks twenty-eight through forty, focuses on rapid fetal growth and preparation for labor. During this period, the brain triples in size and the cerebellum develops drastically. The cerebellum coordinates voluntary movements, controls posture and balance, refines motor skills, and is often called the “little brain” due to how much it contributes to everyday functioning.
The brain's surface area increases as well, and grooves and ridges form, which allow the brain to fit within the skull while also expanding its capacity for complex thinking. However, growth during the third trimester is not just about brain size. During this growth, the brain begins to form billions of neural connections. Neural connections allow different parts of the brain to communicate with one another. These connections are extremely important for strategic thinking, language development, motor coordination, and emotional regulation. Due to so much of the brain’s growth occurring during the third trimester, being born preterm interrupts or alters a critical stage of development. When a baby is born early (preterm), the development of their brain does not stop; their brain continues to grow in a NICU. While modern medical care has improved survival rates for babies, the sudden change in environment can influence how certain brain structures develop and how neural connections form.
These differences in development of the brain can affect a child in many ways. Cognitive development can be affected, which is a lifelong process of growth in mental abilities, including thinking, reasoning, memory, and problem-solving. In a real-life scenario, this may affect school by requiring extra time to complete assignments and additional academic support. According to the NIH, research has found that the earlier a baby is born, the higher the likelihood of experiencing learning difficulties and developmental delays. However, it is extremely important to understand that not every child born preterm will face these outcomes. Most who are born early develop normally and succeed academically and socially.
Another area preterm birth may affect is motor development. Because the cerebellum develops so much during the third trimester, as mentioned earlier, being born early can sometimes influence a person's balance, coordination, and fine motor skills. Fine motor skills involve smaller movements such as writing, tying shoes, buttoning clothes, and using scissors. Gross motor skills include larger movements like running, jumping, skipping, and/or maintaining balance. Some children born preterm may take slightly longer to develop these skills compared to children born at full term.
Advances in medical care have been improving outcomes for babies. NICUs have been a great assistance for premature babies because doctors can closely monitor infants as their brains and bodies develop. Another important advancement is the use of antenatal corticosteroids, which are medications given to pregnant mothers who are at risk of delivering early. These steroids help speed up the development of the baby’s lungs and other organs before birth. This treatment can greatly reduce complications for premature infants and improve their chances of healthy development.
Even though being born early can sometimes affect development, it does not determine a child’s future. Many children who were born preterm grow up to do well in school and lead healthy lives. With early support from doctors, therapists, teachers, and families, children can continue to develop important skills and overcome many challenges. As research continues to improve our understanding of preterm birth, medical professionals are better able to support these children and help them reach their full potential
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