The death rate of premature infants dropped from 90% to 20% from 1950 to 2000. The drop is associated with advances in critical care. Fewer premature infants are dying because advanced in care allow doctors to treat conditions that would previously lead to death. While the decrease in infant deaths is a positive sign in terms of medical care, it may come at a cost. Though death rates are lower, cognitive or intellectual disability rates may be higher. Researchers believe an additional focus needs to be paid to preventing premature birth and reduce the rate of intellectual disability.

Prior to 2000, the majority of intellectual disabilities in children were associated with infections and metabolic diseases, but researchers say that changed by 2000. Up to 15% of intellectual disabilities can now be associated with advanced medical care; specifically, intensive care required after premature delivery. Advances in intensive care, particularly in neonatal intensive care, have decreased the rate of infant deaths associated with premature delivery, but it cannot stop the long-term side effects associated with prematurity – specifically cognitive or intellectual impairment.

When previous studies and medical literature were reviewed, authors found a dip and subsequent rise in low birth weight births. In 1950 about 8.3% of infants were born prematurely. That number dropped to 6.7% in the 1980s but rose again to 8.18% in 2000. At the same time, there was an extreme drop in infant deaths associated with prematurity – 90% to 20%. More infants are surviving premature delivery, but these infants grow into children with an increased risk of intellectual disability.

Current literature is lacking in consistency when it comes to predicting overall risk with some studies reporting a mere 2% risk of intellectual disability with premature birth and other studies reporting up to 27% risk. It is estimated that the risk hovers somewhere between 10% and 15%, but further research is needed to resolve discrepancies.

Researchers believe a renewed focus on preventing premature births would reduce the rate of intellectual disability by simply reducing the number of children receiving critical care. According to researchers, “Both the general association between poverty and ill health, as well as the specific association between [intellectual disability] and maternal factors, have been known for more than a century. The challenge of the 21st century will be to address the factors that improve developmental outcomes for all children.”

Source: Jeffrey P. Brosco, MH, Ph.D.; Lee M. Sanders, MD, MPH; Monica Dowling, Ph.D.; Ghislaine Guez, MD, MBA. Impact of Specific Medical Interventions in Early Childhood on Increasing the Prevalence of Later Intellectual Disability. JAMA Pediatr. 2013;():1-5. doi:10.1001/jamapediatrics.2013.1379.