Extremely Preterm Birth and Its Consequences—The ELGAN Study

Dammann O, Leviton A, O'Shea TM, and Paneth N, eds. Extremely Preterm Birth and Its Consequences—The ELGAN Study. (Clinics in Developmental Medicine). London: Mac Keith Press; 2021 (ca 250 pages). ISBN 978–1-911488–96–5. £ 95.00

Over the last decades, improvement in perinatal and neonatal care has led to vastly increased survival rates for extremely low gestational age newborns (ELGAN). Among the most relevant prospective longitudinal studies in the field, the ELGAN Study contributed and continues to contribute to this dynamic by providing crucial knowledge on the mechanisms that lead to preterm birth, its consequences, and the causes and pathophysiology of brain damage which represents the major disabling morbidity in survivors.

The book organized in four parts, presents a comprehensive overview of some of the main findings of the ELGAN study from the past 20 years. What makes this volume particularly interesting is the fact that the authors have brilliantly succeeded in proposing to the reader not only the synthesis of the milestones of such a broad and multidisciplinary study project, but also to convey how these discoveries have influenced our thinking as clinicians. All this in a concise, systematic, and easy to read way.

The first part discusses antenatal risk factors for adverse short- and long-term outcomes, with a specific focus on the role of placental conditions, defined according anatomopathological and microbiological criteria, as mirror of intrauterine exposures that affect fetal brain integrity. The second part, in which the adverse impact of systemic inflammation is extensively described, summarizes the huge work done in exploring how early postnatal illness-severity and neonatal morbidities may affect later development of the extremely preterm born child. In the third and fourth part of the book the focus is moved from risk factors for adverse neurodevelopmental outcomes to the measurable indicators of structural brain damage and neurologic dysfunction, respectively, up to the age of ten. The structural brain abnormalities are described according to a large body of investigation based on ultrasound and magnetic resonance imaging technologies, which has consistently characterized the ELGAN study. The indicators of functional abnormalities described in the final chapters of the book are derived from a broad-spectrum, long-term diagnostic approach that comprehensively covered different domains of the child development (cognitive, motor, and behavioral). With regard to these last two book's sections, not only the clinical data presented is of central interest but also the peculiar example provided by the ELGAN study with respect to the use of high standards of measurement and data collection procedures, and the high follow-up rates maintained throughout the entire study period.

I wish to congratulate the authors of this excellent book which is already, in fact a reference for my generation and the future generations of clinicians and researchers dedicated toward pre- and post-discharge care of the ELGAN, all disciplines included.

Publication History

Article published online:
30 July 2021