Matern Health Neonatol Perinatol. 2015 Oct 19;1:24. doi: 10.1186/s40748-015-0025-2. eCollection 2015.
Newborn intensive care survivors: a review and a plan for collaboration in Texas.
Maternal health, neonatology and perinatology
Alice Gong, Yvette R Johnson, Judith Livingston, Kathleen Matula, Andrea F Duncan
Affiliations
Affiliations
- Department of Pediatrics, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio Texas, 78229 USA.
- Cook Children's Hospital, 1500 Cooper St., Dodson Specialty Building, 2nd Floor, Fort Worth, TX 76104 USA.
- The University of Texas Health Science Center-Houston, 6431 Fannin St.,, Houston Texas, 77030 USA.
PMID: 27057341
PMCID: PMC4823685 DOI: 10.1186/s40748-015-0025-2
Abstract
BACKGROUND: Neonatal intensive care is a remarkable success story with dramatic improvements in survival rates for preterm newborns. Significant efforts and resources are invested to improve mortality and morbidity but much remains to be learned about the short and long-term effects of neonatal intensive care unit (NICU) interventions. Published guidelines recommend that infants discharged from the NICU be in an organized follow-up program that tracks medical and neurodevelopmental outcomes. Yet, there are no standardized guidelines for provision of follow-up services for high-risk infants. The National Institute of Child Health and Human Development Neonatal Research Network and the Vermont Oxford Network have made strides toward standardizing practices and conducting outcomes research, but only include a subset of developmental follow-up programs with a focus on extremely preterm infants. Several studies have been conducted to gain a better understanding of current practices in developmental follow-up. Some of the major themes in these studies are the lack of personnel and funding to provide comprehensive follow-up care; feeding difficulties as a primary issue for NICU survivors, families, and programs; wide variability in referral and follow-up care practices; and calls for standardized, systematic developmental surveillance to improve outcomes.
FINDINGS: We convened a one-day summit to discuss developmental follow-up practices in Texas involving four academic and three nonacademic centers. All seven centers described variable age and weight criteria for follow-up of NICU patients and a unique set of developmental practices, including duration of follow-up, types and timing of developmental assessments administered, education and communication with families and other health care providers, and referrals for services. Needs identified by the centers focused on two main themes: resources and comprehensive care. Participants identified key challenges for developmental follow-up, generated recommendations to address these challenges, and outlined components of a quality program.
CONCLUSIONS: The long-term goal is to ensure that all children maximize their potential; a goal supported through quality, comprehensive developmental follow-up care and outcomes research to continuously improve evidence-based practices. We aim to contribute to this goal through a statewide working group collaborating on research to standardize practices and inform policies that truly benefit children and their families.
Keywords: Collaboration; Developmental follow-up; Outcomes research; Preterm birth; Standardized practice
References
- J Fam Psychol. 2007 Sep;21(3):398-406 - PubMed
- J Perinatol. 2012 Jul;32(7):552-8 - PubMed
- Pediatrics. 2007 Oct;120(4):e953-9 - PubMed
- Early Hum Dev. 2006 Mar;82(3):173-83 - PubMed
- Semin Perinatol. 2003 Aug;27(4):333-42 - PubMed
- Arch Pediatr Adolesc Med. 2012 Feb;166(2):178-84 - PubMed
- Neonatology. 2008;93(4):284-7 - PubMed
- J Matern Fetal Neonatal Med. 2011 Jun;24(6):774-7 - PubMed
- J Matern Fetal Neonatal Med. 2016;29(7):1131-8 - PubMed
- Dev Psychol. 2006 Jul;42(4):627-42 - PubMed
- J AAPOS. 2007 Dec;11(6):541-5 - PubMed
- Pediatrics. 2015 Jun;135(6):1082-92 - PubMed
- N Engl J Med. 2007 Sep 20;357(12):1190-8 - PubMed
- Child Care Health Dev. 2015 Sep;41(5):722-33 - PubMed
- Pediatrics. 2008 Nov;122(5):1119-26 - PubMed
- Early Hum Dev. 2015 Feb;91(2):97-102 - PubMed
- Clin Perinatol. 2010 Mar;37(1):217-45 - PubMed
- Pediatrics. 2008 Oct;122(4):e948-9 - PubMed
- J Pediatr. 2015 Feb;166(2):289-95 - PubMed
- BMC Pediatr. 2014 Nov 17;14:279 - PubMed
- Med Health R I. 2010 May;93(5):151-3 - PubMed
- J Dev Behav Pediatr. 2012 Apr;33(3):202-13 - PubMed
- J Perinatol. 2012 Apr;32(4):293-8 - PubMed
- N Engl J Med. 2012 May 31;366(22):2085-92 - PubMed
- Acta Paediatr. 2012 Jun;101(6):569-73 - PubMed
- Pediatr Clin North Am. 2013 Feb;60(1):49-74 - PubMed
- Clin Perinatol. 2010 Mar;37(1):29-47 - PubMed
- J Am Acad Child Adolesc Psychiatry. 2009 Sep;48(9):909-18 - PubMed
- Pediatrics. 1981 Jul;68(1):36-44 - PubMed
- J Perinat Neonatal Nurs. 2012 Jan-Mar;26(1):90-8 - PubMed
- Paediatr Child Health. 2006 May;11(5):267-70 - PubMed
- Pediatr Pulmonol. 2015 Nov;50(11):1090-8 - PubMed
- Clin Perinatol. 2008 Dec;35(4):777-92, vii - PubMed
- J Perinatol. 2014 Jan;34(1):71-4 - PubMed
- N Engl J Med. 2008 Apr 17;358(16):1672-81 - PubMed
- J Paediatr Child Health. 2012 Sep;48(9):789-93 - PubMed
- Pediatrics. 2000 Nov;106(5):1070-9 - PubMed
- JAMA. 2014 Sep 17;312(11):1105-13 - PubMed
- N Engl J Med. 2015 May 7;372(19):1801-11 - PubMed
Publication Types