Expanding the definition of long-term follow-up to late adulthood.

Abstract

In the United States, NICUs with training programs for fellows have follow-up programs for extremely preterm and very preterm infants who are considered at greatest risk of postdischarge neurodevelopmental morbidity. Late preterm (LPT) births (34–36 weeks) were for many years considered low risk, and their vulnerability was underestimated. Over the past few decades there has been a significant increase in the number of LPT births, related in part to induction of labor and cesarean delivery births and to a variety of risk factors.1,2 There has also been a proliferation in the number of studies reporting increased neonatal and postdischarge morbidities within the LPT population. The level of physiologic maturation has been shown to place these infants at increased risk of a spectrum of medical problems, including hypothermia, respiratory disorders, hypoglycemia, jaundice, immunologic problems, increased susceptibility to infection, and feeding problems.3 Vulnerability of the brain is now also recognized. The second half of gestation is a critical period of brain … Address correspondence to Betty R. Vohr, MD, Department of Pediatrics, Women and Infants Hospital, Professor of Pediatrics, Alpert Medical School of Brown University, 101 Dudley St, Providence, RI 02905 E-mail: bvohr{at}wihri.org