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Paper Chase

Long-term follow-up of infants discharged from neonatal intensive care units.

JAMA. 3 24, 1989;261(12):1767-72.
McCormick MC.

Joint Program in Neonatology, Harvard Medical School, Boston, Mass.

Abstract:

A recent review of 20 years' experience with neonatal intensive care for very-low-birth-weight infants provides reassurance that such care saves lives and that an increasing proportion survive free of moderate to severe handicap. However, data on the health status of these survivors largely reflect status in infancy. An increasing literature suggests that such early findings may be insufficient to characterize later outcomes, particularly those problems encountered as the child enters school. Since the specific health and developmental problems that might be encountered are still being defined, a broad conceptual framework is applied to organize a review of the existing literature. Some areas of concern about longer-term outcomes emerge, as well as important areas for which data are lacking. Further definition of longer-term outcomes is critical at the policy level to assess the utility of neonatal intensive care unit interventions and at the individual level for counseling families as to the health and educational needs of these children.

Existing data on the health status of survivors of neonatal intensive care reflect status in infancy and are insufficient to characterize later outcomes, particularly problems encountered when the child enters school. A broad conceptual framework is applied to review the existing literature on longer-term outcomes of very low birth weight infants and to assess the limitations of activities of their daily living and behavioral/mental health. Areas of concern and important areas for which data are lacking are discussed and the need for further definition of longer-term outcomes is emphasized for counseling families as to the health and educational needs of these children.