PATHWAYS TO DEVELOPMENTAL OUTCOMES IN PRETERM INFANTS

Birthweight-specific mortality has decreased tremendously over the past several years due to the use of surfactant and improvements in obstetric and neonatal intensive care. Consequently, there has been an increase in the number of preterm births over this time. As an example, from 1985 to 1995 the rate of preterm births rose 12%, from 10.0% to 11.0% of all births (March of Dimes Birth Defects Foundation, 1997). This increase has led to a growing concern about the consequences of low birthweight and its associated medical complications for infants’ developmental outcomes. Even moderately low birth weight infants are sometimes shown to be developmentally delayed and/or to suffer visual-motor impairments. Nonetheless, a great percentage of preterm infants evidence few if any developmental delays, and for many such infants initial delays virtually disappear over the course of the first few years of life. A complex web of biological, social, economic, and cultural factors explains the contrast between the seeming resilience of certain preterm infants and the vulnerability of others.