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Protecting the premature brain: current evidence-based strategies for minimising perinatal brain injury in preterm infants
  1. Charlotte L Lea1,2,
  2. Adam Smith-Collins1,2,
  3. Karen Luyt1,2
  1. 1Department of Neonatal Neuroscience, St Michael's Hospital, Bristol, UK
  2. 2School of Clinical Sciences, University of Bristol, Bristol, UK
  1. Correspondence to Dr Charlotte L Lea, Department of Neonatal Neuroscience, St Michael's Hospital, Office G2, Southwell Street, Bristol BS2 8EG, UK; charlotte.lea{at}bristol.ac.uk

Abstract

Improving neurodevelopmental outcome for preterm infants is an important challenge for neonatal medicine. The disruption of normal brain growth and neurological development is a significant consequence of preterm birth and can result in physical and cognitive impairments. While advances in neonatal medicine have led to progressively better survival rates for preterm infants, there has only been a modest improvement in the proportion of surviving infants without neurological impairment, and no change in the proportion with severe disability. The overall number of children with neurodisability due to prematurity is increasing. Trials investigating novel therapies are underway and many have promising early results; however, in the interim, current treatments and management strategies that have proven benefit for neurodevelopment or reduction in neonatal brain injury are often underutilised. We collate the evidence for the efficacy of such interventions, recommended by guidelines or supported by large meta-analysis or randomised control trials. We address controversies that have hindered uptake and problems with translating research into practice. We then look to the future of preterm neuroprotective care.

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Footnotes

  • Contributors KL suggested the topic for the review. CLL, AS-C and KL planned the structure of the article. CLL conducted the literature review and wrote the review article. AS-C and KL provided comments, supervision and support throughout.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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