• Monday, August 08, 2022

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More premature babies survive thanks to advances in pediatric neurology

By: Eastern Eye Staff

Premature babies used to be such bad news for doctors and mothers. The number of premature babies that went away thanks to lack of information or advances that allowed them to survive made this topic one that needed to be explored and after many years, we can see progress and advances that help doctors save the life of these babies.

For general knowledge, most pregnancies last approximately 40 weeks. According to Francisco D’Agostino, babies born between 37 and 42 weeks of gestation are considered full term. Babies that are born before 37 weeks gestation are defined as premature.

There are many advances in neonatology and neuropediatric that have allowed, in recent years, to substantially increase the survival rate of premature newborns, for which there are now care protocols that involve, from the loss of temperature, the benefit of breast milk, up to cardiological, ophthalmological and neurological monitoring, which is vital, according to Dr. Oscar González.

He explains that there are several types of premature baby: early preterm, moderate, and late. “And although the central nervous system is configured in the first trimester, it is in the last when the growth of the structures occurs and processes begin that can be interrupted by premature birth, and to a lesser or greater degree the compromise of the system will be seen in the central nervous”.

That makes those last weeks vital for the good development of the baby. However, as we already know, is not always the case. About 450,000 babies in the United States alone are born too soon and 15 million babies are born preterm around the world, concern data however, all the doctors can do is be ready for the situations that involve newborns.

The statistics on the consequence of being premature can be concerning, but with the recent advances in pediatrics we hope that these will be way less in a few years. Babies who may develop a severe disability secondary to early birth represent a 22%. Newborns that may develop a moderate disability or special needs from premature birth: 24%. Those who may develop a mild disability: 34% and 20% of all those born at 36 weeks gestation or earlier will have no long term effects from their prematurity.

The premature baby is noble

Dr. González explains that, even though the premature baby may have bleeding in the germinal and ventricular matrix, as well as affectation in his neuronal system due to his early birth, it is also very noble. “In daily practice we are pleased to see that, based on all the interventions we carry out, the pathologies that have affected the central nervous system, for the most part, can be minimized.”

He adds that therapy is essential during the first year of the premature baby, because in this time it is observed how simple neural circuits will evolve into complex neural circuits. In some cases, medication may be necessary.

In his opinion, it is necessary to monitor the patient over the years because there may be immediate, mediate or late consequences that warrant a neurological evaluation. “For this, imaging studies are carried out and follow-up is done with cerebral echo-sonography depending on the commitment. A more stable development is expected until the first year of age, to then go to more complete studies, such as brain MRI”

Hearing and vision

The specialist warns that in the case of premature babies, monitoring of hearing and vision is essential within cognitive development and brain development.

“Scans are performed in the ear not only in air conduction but also in nerve conduction. This is done through auditory brain stem and also visual evoked potentials with which better programs are achieved. Retinopathy of prematurity must be avoided, where there is the possibility of bleeding, visual loss or, due to immaturity, vascular development can also be affected”.

Rehabilitation

Another important point in premature babies is to identify when to refer to cardiology, neurology and / or rehabilitation, as this can even prevent infantile cerebral palsy.

The expert recommends that the premature infant attend early childhood rehabilitation with occupational and speech therapy specialists; Sometimes it even merits neurosensory integration therapies and warns that it is important because the first six months the functions are carried out by the brain stem and are intuitive, after that time the brain takes the command and the baby acquires more skills such as contact with the stimulus and the outside world and the structuring of language.

Understanding and promptly caring for the premature baby and its neurobiological risks is possible thanks to neurology, therapies, physical therapy, and occupational therapy.

For his part, Dr. Gerardo Pérez, emphasizes the need to have a Therapy Unit equipped to attend to any type of situation that may occur with the newborn “there is nothing more desperate for an obstetrician than not having a structure quality, when a baby suffocates or is premature “

Even though the subject can be disturbing, sad or scary; it is important to highlight achievements that represent wins in the medical field. As explained above, having a newborn doesn’t end at the first days. It requires dedication, monitoring and therapy in order to make sure that your baby is developing correctly and if it isn’t, then it is time to do something about it.

The World Health Organization explains that “every year, an estimated 15 million babies are born preterm (before 37 completed weeks of gestation), and this number is rising.” They also point out that “preterm birth complications are the leading cause of death among children under 5 years of age, responsible for approximately 1 million deaths in 2015”. Among their notes, they also highlight that “three-quarters of these deaths could be prevented with current, cost-effective interventions.”

One more time, health and money become and issue. Francisco D’Agostino explains that mothers without the means to save their babies live tragedies every day, which makes the topic even sadder.

However, all we can hope is that these medical advances save more newborns every day and these numbers decrease.

Eastern Eye

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