Placental programming, perinatal inflammation, and neurodevelopment impairment among those born extremely preterm

Jacqueline T. Bangma, Hadley Hartwell, Hudson P. Santos Jr., T. Michael O’Shea & Rebecca C. Fry

Pediatr Res. 2020 Nov 12;1-10.

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Individuals born EP are at significant risk for impaired neurodevelopment. After discharge from the NICU, associations between child’s well-being and factors in the home and social environment become increasingly apparent. We review early life predictors of inter-individual differences in later life neurodevelopment among those born EP. Among biological mechanisms that mediate relationships between early life predictors and later neurodevelopmental outcomes, we highlight evidence for disrupted placental processes, regulated at least in part via epigenetic mechanisms, as well as perinatal inflammation. In relation to these mechanisms, we focus on four prenatal antecedents of impaired neurodevelopment, namely, (1) fetal growth restriction, (2) maternal obesity, (3) placental microorganisms, and (4) socioeconomic adversity. The findings highlighted here may inform efforts to detect and prevent adverse outcomes in infants born extremely preterm.