A study of 72 children aged 14 or 15 born before 33 weeks of gestation found that 40 of them had abnormalities visible on brain scans, compared with one out of 21 teenagers born at full term. Although the scans suggest only minor brain damage, the findings have potentially grave implications for public health.
About 7,000 very premature babies are born each year of whom over 80 per cent now survive. It is known that children born very prematurely have a higher incidence of educational and behavioural problems and the new study, conducted at University College Hospital, London, provides physical evidence of its cause.
Professor John Wyatt, of the department of Paediatrics at University College, said: "What we have found is more like a developmental abnormality than brain damage. You might call it minor brain damage. But with 7,000 births a year it does have public health implications for the early identification of children at high risk to ensure they receive the extra educational help they need.
"With the right help, the majority will do well but our work suggests some are being failed by the system. When an eight-year-old is not doing very well, people forget that he or she was born premature."
Not all those with abnormal scans showed signs of behavioural or educational problems, although there was a link, according to the findings published in The Lancet. Professor Wyatt said: "If you take 100 people off the street, a proportion of them will have abnormalities on a brain scan but you wouldn't say they were brain damaged. For parents of premature babies, what matters is how they are doing, not what is on the scan. If they are doing well there is no reason for concern but if they are having problems they may need referral for specialist assessment."
The most common abnormality revealed by the scans was in the white matter of the brain, which is involved in carrying signals between different areas of the brain and between the brain and spinal cord.
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