The fate of preterm newborns

Key words: Preterm newborn, Neonatal mortality, Long-term neurological outcomes, Neurological disorders, Late preterm infant, Cerebral palsy, Severe disability

The recent progresses made in perinatal medicine have determined an increase in the survival of newborns with lower and lower weight and earlier and earlier gestational age. Although neonatal mortality has decreased in the last few years, the incidence of long-term neurological outcomes, especially in newborns with birth weight less than 750 grams, is still high. These newborns may be at risk for major neurological disorders (i.e. cerebral palsy), but also for minor neurological disorders, such as behavioural disorders, learning disabilities and speech and language impairments. The routine use of cerebral ultrasound has enabled the neonatologist to early identify major cerebral lesions associated with premature birth (periventricular leukomalacia, intraventricular haemorrhage) with probable longterm neurological outcomes. The recent introduction of sophisticated neuroradiological techniques (conventional and unconventional magnetic resonance imaging) has allowed a detailed study of the maturation of encephalon in newborns and a more accurate definition of the long-term prognosis.