A Narrative Review of Neurodevelopmental, Psychiatric, and Behavioral Consequences of Preterm Birth

Abstract

Preterm infants survive into adulthood. However, this survival often comes with increased health and social challenges during adolescence and adulthood, including medical disabilities, learning difficulties, and behavioral and psychological issues. Understanding the long-term outcomes of preterm birth is crucial for developing prevention and treatment strategies, as well as setting future research priorities. Research in this area can be complex due to the need for long follow-up periods and changes in the classification of diseases and outcomes over time, which make it challenging to establish meaningful associations. This narrative literature review aims to consolidate information about the long-term neurodevelopmental, psychiatric, and behavioral outcomes and management of individuals born preterm. Key risk factors affecting preterm survivors include comorbid conditions and socioeconomic status. Prematurity disrupts cortical growth and myelination, making the brain vulnerable to vascular injury. These issues can lead to white matter injury, interventricular hemorrhage, and cerebellar hemorrhage, resulting in motor, language, and learning deficits. Cognitive impairments and difficulties with executive functions can adversely affect academic performance in preterm children. Research consistently shows that early intervention and long-term follow-up can improve neurological impairment. Because the brains of preterm infants are still developing, they require continuous care to support their social and educational development. Early physiotherapy, targeted speech therapy, and individualized education programs tailored to assess school readiness can significantly enhance motor skills and mitigate the neurological impacts of prematurity. Additionally, prenatal interventions and preventive strategies can help reduce the risk of long-term neurodevelopmental impairments. More studies with extended follow-up into adulthood are needed to better understand the social, behavioral, and psychological impacts of prematurity.

Keywords: developmental and behavioral pediatrician; developmental pediatrics; neurodevelopmental outcome; preterm birth; psychiatric conditions.

Figure 1. Adjusted relative risks for incidence of first hospitalization with a selected psychiatric diagnosis after an individual’s 16th birthday about pregnancy outcomes.

Created using Microsoft Word with data from reference [32] (Copyrights (October 25, 2011). Archives of General Psychiatry)

Figure 2. Factors that positively impact behavioral outcomes in preterm birth.

Created using BioRender.com