Birth is a precarious time that coincides with rapid brain development. Problems that arise before, during, or shortly after birth can have lifelong ramifications. Around 1 in 10 babies are born prematurely (before 37 weeks gestation), and those born extremely preterm (<28 weeks) and very preterm (28-32 weeks) account for a sizeable and growing fraction. Indeed preterm birth is the greatest single risk factor for lifelong neurological or cognitive disability, and the youngest babies have particularly high vulnerability.
Prematurity and other common adversities such as being born small for gestational age (due to intrauterine growth restriction) and complications at birth (e.g. asphyxia), all carry increased risk of poor neurodevelopmental outcomes such as cerebral palsy and other neuromotor disabilities, hearing and vision impairments, cognitive and learning difficulties, and behavioural problems (e.g. attention deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD)). The health costs can be immense, as can be the difficulties for the babies and their families.
A big challenge is to identify early on which babies will need extra help. It is difficult to detect adverse events that can disrupt neurodevelopment at the time of occurrence, let alone predict their longer-term consequences. Indeed, cerebral palsy is typically only diagnosed in the second year of life, cognitive and educational deficits later still, long after the damage occurs. There is an urgent need for new diagnostic and prognostic tools to identify babies that need more help, and to guide development of new treatments.