Life after the NICU: targeting modifiable factors to improve neurodevelopmental outcomes in children born extremely...

Infants born preterm are at risk for neurodevelopmental delays and impairments, with the greatest risk for those born extremely preterm or at the limits of viability. Developmental surveillance in neonatal neurodevelopmental follow-up programs is essential for infants born preterm as it allows for early identification of developmental delays and referral to intervention services. Previous studies have identified modifiable home and environmental factors that can alter the neurodevelopmental trajectory of children born preterm. In this review, we discuss how targeting modifiable factors can improve outcomes in the most vulnerable infants born extremely preterm or at the limits of viability. We present The 6 Ps to Promote Positive Neurodevelopmental Outcomes in Prematurity, including post-discharge follow-up in neonatal neurodevelopmental programs, providing enriched environments, physical environment, parent education, parenting style and parent wellness. As parents prepare to go home from the NICU they are faced with uncertainty about their child's future outcomes. Parents often ask, "what can we do for our baby?" We provide evidence-informed recommendations for counseling families during the transition home to enable parents to actively participate in optimizing their child's neurodevelopmental outcomes. IMPACT: Targeting modifiable home and environmental factors may improve neurodevelopmental outcomes in infants born extremely preterm. This article presents The 6 Ps to Promote Positive Neurodevelopmental Outcomes in Prematurity: post-discharge follow-up in neonatal neurodevelopmental programs, providing enriched environments, physical environment, parent education, parenting style and parent wellness. During the transition from NICU to home, parents should be counseled on these modifiable factors and encouraged to actively participate in optimizing their child's neurodevelopmental outcomes.