1. Placental programming, perinatal inflammation, and neurodevelopment impairment among those born extremely preterm
- Author
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Rebecca C. Fry, Jacqueline T. Bangma, Hudson P. Santos, T. Michael O'Shea, and Hadley J. Hartwell
- Subjects
Pediatrics ,medicine.medical_specialty ,Social Determinants of Health ,Placenta ,Gestational Age ,Inflammation ,Review Article ,Nervous System ,Risk Assessment ,Epigenesis, Genetic ,Obesity, Maternal ,03 medical and health sciences ,Child Development ,0302 clinical medicine ,Pregnancy ,Risk Factors ,030225 pediatrics ,Intensive care ,Humans ,Medicine ,Significant risk ,Pregnancy Complications, Infectious ,Socioeconomic status ,Fetal Growth Retardation ,business.industry ,Extremely preterm ,Age Factors ,Infant, Newborn ,Social environment ,After discharge ,medicine.disease ,Obesity ,Socioeconomic Factors ,Neurodevelopmental Disorders ,Infant, Extremely Premature ,Pediatrics, Perinatology and Child Health ,Premature Birth ,Female ,Inflammation Mediators ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Individuals born extremely preterm are at significant risk for impaired neurodevelopment. After discharge from the neonatal intensive care, associations between the child’s well-being and factors in the home and social environment become increasingly apparent. Mothers’ prenatal health and socioeconomic status are associated with neurodevelopmental outcomes, and emotional and behavioral problems. Research on early life risk factors and on mechanisms underlying inter-individual differences in neurodevelopment later in life can inform the design of personalized approaches to prevention. Here, we review early life predictors of inter-individual differences in later life neurodevelopment among those born extremely preterm. Among biological mechanisms that mediate relationships between early life predictors and later neurodevelopmental outcomes, we highlight evidence for disrupted placental processes and regulated at least in part via epigenetic mechanisms, as well as perinatal inflammation. In relation to these mechanisms, we focus on four prenatal antecedents of impaired neurodevelopment, namely, (1) fetal growth restriction, (2) maternal obesity, (3) placental microorganisms, and (4) socioeconomic adversity. In the future, this knowledge may inform efforts to detect and prevent adverse outcomes in infants born extremely preterm. Impact This review highlights early life risk factors and mechanisms underlying inter-individual differences in neurodevelopment later in life.The review emphasizes research on early life risk factors (fetal growth restriction, maternal obesity, placental microorganisms, and socioeconomic adversity) and on mechanisms (disrupted placental processes and perinatal inflammation) underlying inter-individual differences in neurodevelopment later in life.The findings highlighted here may inform efforts to detect and prevent adverse outcomes in infants born extremely preterm.
- Published
- 2020
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