UOne in every 10 children in Italy is born preterm. But for the most part, they begin their journey into the world at the end of their gestational age, and have no problems. Those born very or extremely premature are 0.9-1%: for them, also for how many are born before 27-28 weeks, the chance of survival is always higher, above 70%. But there are many problems that arise years later. Today November 17th marks, like every year, theWorld Prematurity Dayestablished in 2008 and recognized by the European Parliament thanks to the commitment of European Foundation for the Care of Newborn Infants (EFCNI)aimed at raising public awareness about preterm birth.
Premature Babies Day, incidence and problems
The incidence of neurodevelopmental disorders in children born preterm is estimated at around 20%, while infantile cerebral palsy affects approximately 10% of newborns with high degree of prematurity, and represents the most frequent cause of motor disability in children. SINPIA, the Italian Society of Child and Adolescent Neuropsychiatry, underlines the importance of early intervention. An intervention which, he explains Elisa Fazzi, President of SINPIADirector of the Child and Adolescent Neuropsychiatry Unit ASST Spedali Civili and University of Brescia, «is based on strategies of intervention centered on the family and on environmental enrichment».
Interventions that are fundamental because brain maturation, which is the weak point of premature births, can be modified outside of the intrauterine environment. That is, the nervous system knows how to reorganize itself functionally in response to environmental changes and experiences.
The environment is a special medicine for children born prematurely
In recent decades, scientific research has confirmed that the environment can greatly and positively influence brain plasticity: «Represents a “drug” powerful that we have at our disposal from the first days of a preterm baby’s life. And it can positively influence its development in conditions of fragility, acting, for example, through epigenetic mechanisms, regulating gene expression and exercising a protective role.”
«The relationship with mom and dad – underlines Prof. Andrea Guzzetta, full professor of Child Neuropsychiatry at the University of Pisa and Coordinator of the Developmental Age Rehabilitation Sections, SINPIA – is by definition the first environment in which the newborn child should live and grow in “normal” conditions ».
From neonatal intensive care to follow-up
When we talk about early intervention aimed at preterm children we are talking, above all, about a total, conscious and long-term parental involvement. Starting from hospitalization in the Neonatal Intensive Care Unit (NICU), where the postural-motor and sensory development of the newborn is promoted, the stress of mothers and fathers is reduced, and the parent-child relationship is promoted. But even after discharge from the NICU: children and their families must be accompanied through follow-up programs.
The story of Soraya, born at 27 weeks
He has been working in this direction since 1995 in the Neonatal Intensive Care and Neonatology departments of the Sant’Orsola Polyclinic in Bologna, the Odv-Ets Puppy Association: supporting girls and boys born preterm and their families, providing material and psychological support.
This is told by the story of Soraya, born very small, at almost 27 weeks, and weighing less than a kilo.
The psychological support of the Cucciolo association
The psychological support service, in collaboration with the “Renzo Canestrari” Department of Psychology of the University of Bologna, follows the parents both during hospitalization and after discharge. The goal is promote the psycho-neuro-developmental well-being of the newborn, to prevent further hospitalizations and/or developmental and relational difficulties, support an adequate development of the relationship of parent/newborn attachment.
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