Why are premature babies intelligent

Premature Babies: Too Early for the Brain?

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Fabienne still doesn't know why her child was born three months early. On a quiet afternoon in June 2007, the time had come, the contractions got worse, and she finally drove to the nearest hospital near Lausanne. Instead of the 40th week of pregnancy, her son Hugo was born in the 26th week and, weighing just 950 grams, was immediately taken to the intensive care unit. Three days later, they informed the doctors that ultrasound scans of his brain showed profuse bleeding from immature vessels. "I just burst into tears," she recalls.

It was immediately clear to Fabienne and her husband that the prognosis was extremely bleak. The little one was at a very high risk of cerebral palsy, a neurological damage that can lead to a life with severe disabilities. The two agreed and didn't want to do that to their child. "We told the doctors straight away that we didn't want any far-reaching medical measures that would just keep him alive. And the doctors seemed to be relieved," explains Fabienne, who understandably doesn't want to know her surname. The following night was the worst of her life.

This article is included in Spectrum - The Week, 12/2015

The next day, the doctors suggested magnetic resonance imaging (MRI) to confirm the diagnosis before changing Hugo's treatment. With an MRI examination tailored to premature infants, the risk of cerebral palsy can be predicted more precisely because fewer false-positive results occur than with ultrasound examinations. The MRI scans of Hugo's brain showed limited damage to the brain, so the risk of severe cerebral palsy was relatively low. As a result, the parents - 24 hours after the first decision - made a U-turn and agreed to save their son's life if possible.

Thanks to medical advances since the 1970s, more and more premature babies survive, i.e. children born before the 37th week of pregnancy - some clinics are even trying to save premature babies as early as the 22nd week. However, this development is increasingly forcing doctors and parents to make the most difficult decisions, because the earlier a child is born, the greater the likelihood of severe disabilities. 1 to 2 percent of punctually born children suffer from cerebral palsy, 9 percent are born before the 32nd week and 18 percent are born in the 26th week.

However, neuroscientists are increasingly aware of the immature brains of premature babies, which also influences medical decisions and therapies. From the data of some long-term studies, an increased risk of cognitive disorders and behavioral problems in premature birth - in some studies even in every second child. In the meantime, the experts are not only dealing with the causes, but are also investigating the question of how the consequences of premature birth can be avoided and how the children affected can be offered the best possible support. "Unfortunately, we still know far too little to develop optimal strategies," says Petra Hüppi, who works as a pediatrician for neonatology at the University of Geneva and who also studies brain development in prematurely born children.

Too early

Premature births are not that unusual: As statistics from the World Health Organization (WHO) show in 2012, more than every tenth baby is born before the actual date, i.e. 15 million children around the world every year. For most it happens between the 32nd and 37th week; But 1.6 million children are born even earlier, between the 28th and 32nd week, and 780,000 children are even "extremely early", before the 28th week.