Neurological Sequelae of Premature Birth: The Relationship to Prenatal and Neonatal Complications, Birth Weight, and Sex

The improved neonatal regimen for the premature infant, instituted during the last decade, has resulted in the virtual elimination of retrolental fibroplasia^1-3 and a decrease in the incidence of kernicterus.^4,5

However, a considerable number of premature infants have some degree of brain damage manifested in depression of scores on intelligence tests,^6-9 behavior disturbances,^7-11 and cerebral palsy as well as lesser neurological abnormalities.^6,12,13 It might be that these findings are related to the prenatal or neonatal complications associated with prematurity, since brain damage, as manifested by mental retardation, has been found associated with such complications even in the full-term infant.¹⁴ Pasamanick and Lilienfeld¹⁴ have found an association between the incidence of prenatal complications, specifically, bleeding and toxemia, and minor degrees of cerebral damage. Graham et al¹⁵ have reported on the relationship between prenatal complications and anoxia at birth and deficits in development at