State of the Science: The Association Between Perinatal Brain Injury and School Performance in Very-Low-Birth-Weight Infants

Preterm infants are a vulnerable population. Their shorter gestation and lower birth weight place them at greater risk for a variety of health and developmental problems including long-term motor, cognitive, behavioral, and growth problems. This article reviews the epidemiology and morbidities of low-birth-weight infants, with a specific emphasis on perinatal brain injury and its impact on school performance. The pathogenesis of brain injury is complex and not fully understood. The principle brain lesions that underlie much of the neurologic manifestations seen in preterm infants are intraventricular hemorrhage (and its accompanied complication, periventricular hemorrhagic infarction) and periventricular leukomalacia. Nursing participation in advocating for interdisciplinary services including physical therapy, speech therapy, and using position devices and appropriate stimulation while the infant is in the neonatal intensive care unit is essential to maximize functional capacity. Nurses are also uniquely positioned at the forefront of public health to substantially improve school performance in these children by optimizing a child's home environment for maximal environmental stimulation.