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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Long-Term Functioning and Participation Across the Life Course for Preterm Neonatal Intensive Care Unit Graduates
Frances A Carter1, Michael E Msall2
1Department of Psychology, The Center for Early Childhood Research, University of Chicago, 5848 S. University Avenue, Chicago, IL 60637, USA.
Insights
Long-term outcomes for preterm infants require comprehensive life-course assessments beyond survival. Evaluating functional development and providing early support optimizes lifelong health and community participation for these vulnerable children.
Area of Science:
- Neonatal neuroscience
- Developmental pediatrics
- Longitudinal health outcomes
Background:
- Preterm birth poses significant risks to brain development.
- Neonatal morbidities like bronchopulmonary dysplasia and sepsis impact long-term function.
- Current assessments often focus narrowly on survival and early development.
Purpose of the Study:
- To examine life-course trajectories of risk and resilience in the preterm neonatal brain.
- To advocate for comprehensive functional outcome evaluations beyond standard neonatal assessments.
- To identify key areas for proactive support to optimize lifelong well-being.
Main Methods:
- Population-based analysis of functional outcomes across childhood, adolescence, and adulthood.
- Moving beyond traditional neonatal morbidity counts (e.g., BPD, ROP, sepsis).
- Utilizing comprehensive assessments beyond the Bayley Scales of Infant Development.
Main Results:
- Survival alone is insufficient for understanding preterm infant neurodevelopmental outcomes.
- A broader, life-course perspective is crucial for assessing functional trajectories.
- Early and ongoing family and child support significantly impacts long-term functioning.
Conclusions:
- Clinicians must adopt a life-course approach to evaluate preterm infant outcomes.
- Comprehensive assessments are needed to capture the full spectrum of functional development.
- Proactive family and developmental support is essential for optimizing academic, social, and vocational success.
Abstract:
To understand the trajectories of risk and resilience in the vulnerable preterm and neonatal brain, clinicians must go beyond survival and critically examine on a population basis the functional outcomes of children, adolescents, and adults across their life course. Evaluations must go well beyond Bayley assessments and counts of neonatal morbidities, such as bronchopulmonary dysplasia, retinopathy of prematurity, sonographic brain injury, sepsis, and necrotizing enterocolitis. Proactively providing support to families and developmental and educational supports to children can optimize academic functioning and participation in adult learning, physical and behavioral health activities, community living, relationships, and employment.
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