Advances in neonatal–perinatal medicine have resulted in increased survival at lower gestations. Although the incidence of germinal matrix haemorrhage-intraventricular haemorrhage and cystic periventricular leucomalacia is reducing, a new phenotype of preterm brain injury has emerged consisting of a combination of destructive and dysmaturational effects. Consequently, severe neurological disability is reported at a lower rate than previously, but the overall morbidity associated with premature birth continues to present a large global burden and contributes significantly to increased financial costs to health systems and families. In this review, we examine the developmental milestones of fetal brain development and how preterm birth can disrupt this trajectory. We review common morbidities associated with premature birth today. Although drug-based and cell-based neuroprotective therapies for the preterm brain are under intense study, we outline basic, sustainable and effective non-medical, family-centred and developmental care strategies which have the potential to improve neurodevelopmental outcomes for this population and need to be considered part of the future neuroprotection care bundle.
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Contributors RS conceptualised and wrote all sections of the manuscript, created images and obtained permission for use of images. NJR contributed to the sections on preterm brain development, sensory development, brain MRI abnormalities and medical strategies to improve outcomes. CTW-W contributed to the family-centred and developmental care sections. The final critical review of article was done by all three authors.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
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Competing interests None declared.
Provenance and peer review Commissioned; externally peer reviewed.