Over the years the value of textbooks has declined as peer-review literature becomes easily available at your desktop. One of the downsides of this trend is that where multidisciplinary investigations come together it is often hard to delve into unfamiliar literature to explore an area. However, as this volume demonstrates there is still room for cross-cutting reviews such as have been put together here. As interest in the developing ex-preterm child grows, more specialists become interested in the hydra-like effects of preterm birth on the brain and its connectivity. Indeed as we are now seeing this is spreading to adult physicians interested in the abnormal trajectory of lung and cardiovascular development in the survivors of very preterm birth. What sets this book apart is the fresh angle brought to it by Dr Nosarti and Dr Murray, from their perspective as psychiatrists and Dr Hack who is custodian on one of the oldest modern cohorts.
The literature on early childhood development is vast and the areas of neurodevelopment investigated are wide – from behaviour to executive functions and memory. Once we stray beyond early school life, however, the literature becomes thinner and comprises a few well characterized cohorts. Some are survivors of a very different type of neonatal and perinatal care than we have available today but the relevance seems clear as the rates of disabilities and impairments do not appear to be declining and the spectrum of neonatal disease has not really changed, with the exception that increasingly immature groups are now surviving.
The authors are to be congratulated on their effort – they have covered most of the bases with a new and refreshing approach. The studies of Dr Murray and his colleagues of the older UCH cohort from London are extensive and important and Dr Hack has similar groups under review with novel insights into the social and psychological effects in young adults. They have assembled an erudite cast list and the quality of the product is undeniable.
The production of such a book will lead to highs and lows. The strengths of the book are undeniably in the area of focus – adolescence through to adult life. Some of the chapters relating to earlier life are less secure, for example I was surprised to find no real discussion of the prevention of preterm birth by progesterone, no mention of the exciting findings of perinatal neuroprotection studies with, for example, magnesium sulphate, nor any discussion of how perinatal management my worsen outcomes – all of which have been apparent for several years now. As a neonatologist with an abiding interest in this area, I was disappointed that the origins of the spectrum of impairment were not more in perspective, although the chapter on risk and resiliency is novel and valuable.
Nonetheless, what this new volume demonstrates is the flowering of a multidisciplinary approach to long-term neuropsychiatric sequelae and the wider effect of disturbance within the perinatal brain on very long-term outcomes – structural and functional. These reviews are very valuable and the chapters intermesh well. The sections bear reading en masse because of this, but they are also an authorative reference set.
Medical care continues to advance and survivors continue to develop problems as they grow up. Where the next interventions with real impact on these outcomes will come from is unclear, but understanding the effects of prematurity, such as those demonstrated here, will at least give us cause to focus the search on areas which demonstrate continuities and are amenable to enhancement.
