Surfactant era (1990–2002) 2-year outcomes of infants less than 1500 g from a Community Level 3 Neonatal Intensive Care Unit

Premature birth incidence and survival rates are increasing steadily due to advances in obstetric and neonatal intensive care. Those born at the limits of viability are highly at-risk of adverse neurocognitive function over their lifespan, leading to current controversy regarding aggressive resuscitation efforts for these extremely preterm children. However, data from earlier generation cohorts who were born in substantially different eras of neonatal intensive care cannot be relied on to predict outcome of today's newborn. Our review by the crucial variable of birth cohort year shows a changing developmental trajectory in which today's extremely preterm survivor is likely to have fewer severe medical complications, better neurological outcomes, and fewer adverse cognitive late effects. Such data further underscore the importance of concurrently considering medical, familial, socioenvironmental, and neurobiological factors in combination with individual neonatal intensive care center protocols when studying outcomes of the preterm child. This complex, interrelated range of factors directly affects the immature, rapidly developing premature brain. However, ongoing surveillance to detect subsequent delay or impairment and to apply interventional strategies early in the developmental course holds promise for further enhancement of functional outcome.

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Extremely Preterm Birth Outcome: A Review of Four Decades of Cognitive Research

Baron

Rey‐Casserly

2010

Neuropsychol Rev

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Counseling Pregnant Women Who May Deliver Extremely Premature Infants: Medical Care Guidelines, Family Choices, and Neonatal Outcomes

et al. 2009

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Rational, consensus periviability guidelines are well accepted and can be used by all neonatologists, obstetricians, and nurses who provide care to pregnant women and infants at extremely early gestational ages. Pregnant women see these guidelines as highly understandable, useful, consistent, and respectful. When encouraged to participate with attending staff in discussions involving morbidity and mortality outcomes of premature infants and consensus medical practice recommendations, a substantial proportion of parents will choose palliative comfort care for their extremely premature infant up through 25 weeks' postmenstrual age. We believe the choice of neonatal intensive care versus palliative comfort care in extremely premature infants rightfully belongs to medically informed parents. More research is needed to examine how these decisions are made under diverse conditions of culture, religion, and technology.

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Surfactant era (1990–2002) 2-year outcomes of infants less than 1500 g from a Community Level 3 Neonatal Intensive Care Unit

Cited by 2 publications

References 31 publications

Extremely Preterm Birth Outcome: A Review of Four Decades of Cognitive Research

Extremely Preterm Birth Outcome: A Review of Four Decades of Cognitive Research

Counseling Pregnant Women Who May Deliver Extremely Premature Infants: Medical Care Guidelines, Family Choices, and Neonatal Outcomes

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