title: Cognitive development in preterm infants: multifaceted deficits reflect vulnerability of rigorous neurodevelopmental pathways.
abstract: Prematurity remains the major cause of neonatal morbidity and mortality, with 15 million preterm births occurring worldwide in 2010. Infants born less than 37 weeks gestation are at high risk of abnormal neurodevelopmental outcomes, given that the central nervous system is extremely sensitive to an abnormal intra- and extra-uterine environment. Children born preterm have multiple neurodevelopmental sequelae involving dynamic and complex cognitive deficits. Former preterm infants have difficulty with each domain of cognition, including executive function, language, learning and memory, complex attention, perceptual-motor function and social cognition when compared to children born at term. Although deficits are not always severe, even mild delays can be impactful, resulting in a spectrum of outcomes from difficulties in school to an inability to lead an independent adult life. Here, we review current literature on the cognitive outcomes of infants born preterm with a focus on how specific disruption in crucial neurodevelopmental pathways render these children vulnerable to dynamic deficits in cognition as they mature. Further, we highlight promising therapies and intervention strategies aimed at mitigating these deficits, including the use of erythropoietin. With an increasing number of preterm infants surviving, understanding developmental deficits will allow therapies to be developed and optimized, in order to ensure the best outcome for this vulnerable patient population.
authors.affiliation: Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA - jrmaxwell@salud.unm.edu.
authors.forename: Jessie R
authors.initials: JR
authors.lastname: Maxwell
authors.affiliation: Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Tracylyn R
authors.initials: TR
authors.lastname: Yellowhair
authors.affiliation: Department of Pediatric Neurosurgery, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Akosua Y
authors.initials: AY
authors.lastname: Oppong
authors.affiliation: Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Jenny E
authors.initials: JE
authors.lastname: Camacho
authors.affiliation: Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Jean R
authors.initials: JR
authors.lastname: Lowe
authors.affiliation: Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA.|Department of Neuroscience, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Lauren L
authors.initials: LL
authors.lastname: Jantzie
authors.affiliation: Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Robin K
authors.initials: RK
authors.lastname: Ohls
mesh_terms: D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000517:prevention & control; D004921:Erythropoietin; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D004921:Erythropoietin