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Neurological Complications in Preemies

A preemie, also called preterm baby, is a baby that is born before 37 weeks gestation. Babies can be born early for a variety of reasons, including maternal infection, eclampsia, drug and alcohol use and structural problems with the cervix and uterus. Because he is not fully developed, the preemie can have serious short and long-term health problems. Among these are an array of neurological complications.

  1. Intraventricular Hemorrhage

    • Intraventricular hemorrhage, or IVH, is a condition in which the preemie experiences bleeding in the ventricles of the brain. IVH occurs in preemies because their blood vessels are still developing and aren't strong enough yet. It is most common in preterm babies under 30 weeks gestation. The hemorrhage is graded on a scale of one through four, with one representing very minor bleeding and four representing bleeding that negatively affects the brain. Symptoms of IVH include apnea, a reduction in muscle tone and reflex and general fatigue. Treatment for intraventricular hemorrhage is supportive and includes blood transfusions, spinal taps and occasionally surgery.

    Cerebral Palsy

    • Cerebral palsy is a permanent and incurable neurological disorder that causes problems with coordination, reflex and muscle tone. Although cerebral palsy is seen in full-term babies, it is more common in preemies, with 10 percent of severely premature babies developing it, according to Sheena L Carter, PhD. Cerebral palsy is usually a complication of brain damage due to something else, like intraventricular hemorrhage or meningitis. It is more common in preterm babies because their brains are more vulnerable to trauma. Treatment for cerebral palsy consists mainly of therapy, including physical, occupational and speech therapies. In more severe cases, medications are used to control symptoms like seizures, muscle spasticity and pain.

    Periventricular Leukomalacia

    • Periventricular leukomalacia, or PVL, refers to a small area of white matter brain death in areas around the ventricles. PVL's main cause seems to be changes in blood flow that cause damage to the area, but infection and intraventricular hemorrhage are sometimes responsible. It is most common in babies under 32 weeks gestation, especially if they have co-morbidities, such as respiratory distress syndrome or necrotizing enterocolitis. Treatment for periventricular leukomalacia is purely supportive and consists of monitoring the baby's other organ systems and trying to keep them normal. Preemies who develop PVL often go on to develop cerebral palsy or other neurological problems later in life.

    Autism Spectrum Disorders

    • Autism spectrum disorder is an umbrella term for three different types of developmental disorders that cause problems with communication and socialization. The three specific disorders are autistic disorder, Asperger syndrome and pervasive developmental disorder -- not otherwise specified. Asperger syndrome is a milder form of autistic disorder, while pervasive developmental disorder is a diagnosis made for babies and children who do not meet the criteria for the other two disorders. Symptoms of this disorder can range from mild to severe and include avoidance of eye contact, echolalia, delays in speech and language and difficulty accepting minor changes. According to a study published in the April 2010 issue of the Journal of Pediatrics, preterm babies under 26 weeks gestation are eight times as likely to develop an autism spectrum disorder than full-term babies.

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