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The New England Journal of MedicineDefining the Neurologic Consequences of Preterm Birth

Prematurity is the leading cause of neonatal death globally.

Preterm birth, a global concern affecting 15 million infants annually, has profound implications on neurological development. Despite advancements in neonatal care, survivors of preterm birth often grapple with long-term neurologic and developmental challenges.

Key Points:

  • Survivors face a high risk of neurologic and developmental disabilities.
  • Unique forms of brain injury in preterm infants include white-matter injury, germinal matrix–intraventricular hemorrhage, and cerebellar hemorrhage.
  • Advanced neuroimaging techniques have deepened our understanding of primary injuries and secondary dysmaturation effects.

Additional Points:

  • White-matter injury is primarily caused by hypoxia–ischemia and inflammation.
  • Proper nutrition during the preterm period is essential for optimal neurodevelopment.
  • The sensory environment, pain, stress, and parental factors play significant roles in the neurodevelopment of preterm infants.


  • A combination of unique brain injuries and altered brain development underpins the adverse neurodevelopmental outcomes in preterm infants.

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Did You Know?
Despite advances in perinatal health care, there has been no decline in the high incidence of cognitive impairment and social and emotional challenges among children and young adults born preterm.

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