“Of the 480,483 births registered in 2017, according to the Demographic and Family Health Survey (ENDES), prematurity represented 21.8% of the total, of which 6.4% are extremely premature; that is, they weighed less than a kilo and a half. Due to good care in newborn units and existing technology, survival has increased; however, little has been analyzed about the possible sequelae or the need for neurological care in premature babies”, says Dr. Pamela Muñoz, pediatric neurologist at our clinic.

What baby is considered premature?

Babies born before 37 weeks are premature. Extremely premature babies are born before 28 weeks and weighing less than 1,500 grams.

What are its main causes?

The main causes are related to pre-existing maternal chronic diseases (diabetes, hypertension, rheumatic diseases, etc.), pregnant women older than 36 years, multiple pregnancies, maternal smoking.

What are the chances that the premature baby will have a neurodevelopmental disorder?

With a birth weight of less than 1,500 g, the probability of suffering from a neurodevelopmental disorder is between 5 and 10%. If it is less than 1000 g, 20% and in weights less than 800 g up to 40%.

What neurological sequelae can a premature baby have in the future?

The premature baby is born in a phase of brain development called: organization, where the different neurons make connections or synapses, so if this phase is not completed, all these connections could not occur properly, producing a series of difficulties in the development of the baby´s brain:

• Risk of presenting motor alterations, this occurs due to lesions in the connections of neurons (motor circuits) related to movement control, among which include infantile cerebral palsy, motor delay, hypertonia and hypotonia.
• Language delays and difficulties.
• Behavioral difficulties, such as behavior and attention problems.
• Attention deficit and hyperactivity.
• Learning difficulties, such as memory disturbances and cognitive deficits (intellectual disability).
• Autism spectrum disorder.
• Anxiety disorders and other emotional and psychiatric problems

Recommendations of the specialist:

Parents of a premature baby should be informed that their baby is considered to be at high neurological risk and with an increased possibility (in relation to other babies) of presenting some difference in their neurodevelopment, therefore:

• They should stimulate their baby regularly and consult with their pediatrician about concerns regarding their development.
• Go to check-ups with a neuro-pediatrician, who will monitor the neurodevelopment of the baby to detect any type of abnormality in its development. Controls are recommended at 3, 6, and 12 months, and at 2, 5, and 7 years.

Dr. Pamela Muñoz
Pediatric neurologist at Clínica Ricardo Palma