Impact of Prematurity on Development

Impact of Premature Birth on Development

Years ago, premature birth almost always meant death for the baby. Today, however, we have the technology to nurture these infants' development, and many of them survive to lead normal, healthy lives. Although, very premature infants (that is, those born before about the fifth month) are still not likely to survive, many born at five months and older will thrive. Some preterm babies, however, do have many obstacles to overcome. There are a variety of medical problems that affect some of them, they may have impaired mental or physical conditions, and they may be looked upon by others in their environment as slow, or they might be treated differently because they were premature. All of these factors, plus a few more that will be discussed, affect the development of preterm infants into their adolescent years, and sometimes beyond.

Many preterm babies are born with medical problems because they simply were not ready to come into the world yet. They will not have very developed primitive reflexes, and they may look a little strange, with translucent skin, misshapen ears, and fine hair covering their entire bodies. One of the biggest problems for premature infants is a condition called Respiratory Distress Syndrome (RDS), in which the lungs do not produce enough surfactant, which is the substance that keeps the airsacs in the lungs from collapsing. If not treated in time, the infant's brain will become oxygen deprived, which would lead to death. It can cause some brain damage. Another condition that often affects premature babies is Patent Ductus Arteriosus (PDA). This happens when the ductus arteriosus, which connects the pulmonary artery to the aorta, doesn't close, leading to the infant's blood not being properly oxgenated. This can also lead to brain damage if not caught in time. Premature infants also may just stop breathing, which is called apnea. This is why they must be closely monitored, for without close supervision, they could die.

Another medical condition common to premature infants which affects the brain is Intraventricular Hermorrage, where the blood vessels in the brain bleed. This affects most premature babies, but it is not very severe in most cases, and is easily treated. In more severe cases, it can be associated with cerebral palsy or mental retardation.

Premature infants generally show a lower IQ than full term babies, but only by about 10 points. This still puts them in the same IQ range as their full term peers. They are more likely to need special education classes later in life, though, and more likely to have to repeat a grade in school. This is most likely because some premature infants have been shown to have some cognitive impairment when compared to full term infants of the same age. Their memories are not as good, and their information processing speed is significantly lower.

There have been many studies performed that compare the cognitive performance of preterm infants with full term infants. One study in particular, performed by Susan A. Rose and Judith F. Feldman, tested the memory and the processing speed of preterm children versus full term children at the age of eleven. They used the Colorado Specific Abilities Test, which is a comparison of eight paper and pencil tasks the child must perform. This test showed the degree of these four abilities: memory, perceptual speed, spatial ability, and verbal ability. They also used the Cognitive Abilities Test (CAT) which is a detailed exam of memory and speed. This test shows us exactly what aspects of speed and memory it is that pre and full term children differ in, and how much this difference actually affects them. It is comprised of a set of basic cognitive tasks used to study the individual elements of cognitive processing.

The results they came upon are detailed, but they are not very surprising. In the general memory section and learning (recall), full term children performed slightly better than preterms. The researchers proposed an interesting theory as to why preterms have poor memory. They said that it might be directly related to the presence, and in particular, the severity of Respiratory Distress Syndrome (RDS), because the hypoxic-ishemic episodes that come with it damage the brain.

In the section of the test, the Sternberg Memory Search, which tested the children's ability to recall pictures, the preterms made errors significantly more often than the full term children did over the 24 trials. The premature children took a significantly longer amount of time to complete all the tasks. When they were simple tasks, such as when there was only one choice, the premature children were very fast in choosing the answer, but when the amount of choices increased, so did the amount of time it took them to answer it.

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