Premature infants: about 6% of births today.
Progress and effectiveness of medicine to deal with these fragile and threatened lives, while worrying about the very serious sequelae of these special births. Indeed, it may be exposed to problems of growth, lung function or psychomotor development. Of course, not at all preterm births, it depends, among other things, the degree of prematurity. If we stick to the WHO criteria, the child refers to any premature birth before 37 weeks gestation (late of the Week 23 remains extremely reasonable limit). Specify sweats, to realize the consequences of prematurity, studies generally use comparisons between a group of children born before 32 weeks (category "extreme prematurity") and a group of term infants. This is not to be considered only in terms of cognitive development of children in school, but also in a socio-emotional, such as in reports that the premature infant with his parents, peers and in the image he is forging itself ("self").
The big change is a sharp decrease in spontaneous preterm births: pregnancy are much better monitored and the causes of prematurity far better known. Premature births, currently, resulting, in part, in vitro fertilization, the source of multiple pregnancies and the other birth attendants themselves, that cause birth if they believe baby has a better chance of survival outside the womb. Gender inequalities are enormous: the girls are dying less, have fewer complications, and their fate is far better than boys.
The normal IQ but an attention deficit.
Cognitive development and socio-emotional development of every child is affected by health or premature babies often have more health problems and require more medical care. The hospital stays, especially during the first year of life are also more numerous. Health is taken into account in its multiple effects, such as on physical performance of the student, his taste for sport and recreation, its relations with others and also the image he has of himself same.
Regarding cognitive development, we can say that premature infants have a normal IQ. However, the distribution of values shows an average IQ of less than those seen in term infants, this lag is proportional to the degree of prematurity (there is also better results for girls). When one looks particularly performance in the tests reflecting the development scales (mathematics, language, reasoning, logic ...), we realize that premature infants have more difficulty in integrating complex information, reasoning logic and capacity for spatial orientations. They are particularly difficult to process multiple information simultaneously. Fallible ability to perceive, process and integrate the different information at the same time seems to be the cause of multiple cognitive problems that these children have to solve.
What goes with a problem of lack of concentration (attention deficit) almost unanimously identified. One study also showed that premature infants often treat the meaning of words in the same way that children process sound futures. When telling a story, for example, they can not understand its meaning, its meaning. These differences in language processing express the difficulty that the premature access to high levels of treatment that the apprehension of semantic relations. Many researchers and practitioners have therefore considered hyperactive. However, when looking closely at the data of the specific literature, only the concentration difficulties are reported in premature infants.
A temperament more fragile than the term infants.
Especially during their first year, unless they adapt easily to different situations, are more restless and more negative mood, less regular, that is to say less predictable in their cycles of activity and rest, and also less adventurous. During their second year of life this passivity persists even when the mood becomes more predictable and positive. In relations between the child and his parents, the immaturity of special premature baby can be a source of challenges to parents and hinder their interactions. They are also less able than others to control their emotions and supporting their attention in exchange with their parents. Their facial expressions are less easy to decipher. It also happens that the attachment to the mother is less immediate, more distant (the separation and lack of physical contact of the first month). But this will dissipate fairly quickly. Compared to the influence of social environment on cognitive development, at least until the age of 10, the infant is particularly sensitive to family stability. While this stability indices have little influence on school performance of children born at term, however they have negative effects on academic performance in preterm infants.
If anxiety or the tendency to depression, is not found in all studies, many of them relate, however, that these children have problems socializing with other children the same age: they are often withdrawn, more introverted, with no or very few friends, mainly because of their own isolation (more than a rejection of other comrades). A possible explanation could hold for the difficulty experienced by premature infants to treat many stimuli simultaneously.
There are also their inability to integrate the expectations of others. These relationship problems also persist into adolescence, a period when social relationships are of major importance for the individual. They have fewer friends, are a source of annoyance to others, but are more often bullied or manipulated. But if these problems do not seem to persist into adulthood, other challenges remain, especially in terms of physical health and their image of themselves.
This shows that prematurity is a risk factor for cognitive, emotional and social development of the child. However many factors may contribute positively to the future of the child born prematurely and combat the effects of an early birth.
When prematurity involves life-threatening.
The survey "Epipage" (epidemiological study on low gestational age) is the first nationwide, launched in 1997 by the National Institute of Health and Medical Research. It is intended to assess the health of preterm infants from birth to age 5. First results: almost all of those born at 32 weeks survived, it is also the case for 78% of births at 28 weeks, half at 25 weeks. However, none of the babies born at 22 and 23 weeks (about 5 months), could not be saved.
The survey also notes that the decision to limit care is causing all gestational ages combined, half of very premature death. They incur because of severe neurological sequelae and significant developmental delays, that medical teams should necessarily take into account to avoid aggressive therapy. The question of euthanasia highly sensitive (by child) does not concern the adult mission team member information accompanying the end of life, which must soon make its conclusions, of moreover placed the issue of extreme prematurity with its program of reflection.