A parable wrapped in an enigma: population-based assessments of outcomes among high-risk neonates are even less achievable in the age of clinical informatics.

Abstract

A of the biomedical research literature in perinatal care is the article on sequelae of high-risk infants. These articles variously examine growth, cognitive, neurodevel-opmental, behavioral, health, and other outcomes of low-birth-weight, preterm, or intrauterine growth-restricted neonates who survived the neonatal intensive care unit (NICU) or neonatal period. More recently, a new genre of articles has emerged that provides metaanalytic or systematic reviews of the results of these articles on sequelae of high-risk infants. 1-5 A review of the purposes, analytic strategies, conclusions, and implications of these studies seems worthwhile. In this commentary, I focus especially on the comments and suggestions of other researchers who have considered the methodological complexities and study designs required for scientifically valid, clinically useful studies. 6-10