PEDIATRICS Vol. 114 No. 5 November 2004, pp. 1377-1397 (doi:10.1542/peds.2004-0866)
SUPPLEMENT ARTICLE |
Follow-up Care of High-Risk Infants
A workshop on the follow-up care of high-risk infants sponsored by the National Institute of Child Health and Human Development, National Institute of Neurologic Disorders and Stroke, and the Centers for Disease Control and Prevention was held June 19-20, 2002. There are currently no standardized guidelines for provision of follow-up services for high-risk infants in tertiary care centers despite the requirement for follow-up clinic experience in the 97 approved neonatal fellowship training programs in the United States and the increasing number of centers participating in multicenter networks. As the total number of survivors at risk for neurodevelopmental morbidities increases, many clinical research questions have surfaced that can only be answered by long-term follow-up studies. There is increasing awareness of the importance of long-term outcome in randomized, controlled trials, because perinatal interventions may dramatically alter later growth and development. There is also an increased recognition of the potential disconnect between perinatal outcomes and long-term outcomes. The administration of oxygen and postnatal steroids are prime examples of interventions that may have immediate positive effects but negative long-term effects. In addition, multicenter studies have identified significant center differences in the management and developmental outcome of high-risk infants. These findings led to the recognition of the need to improve standardization and comparability of methodology and data collection within and among centers and networks as a first step toward research to improve the long-term neurodevelopmental outcome of high-risk infants. The workshop participants met to define optimal methods to assess the outcome of high-risk infants, identify gaps in knowledge about the neurodevelopmental outcome of high-risk infants, and prioritize research efforts in response to these gaps.
Abbreviations: NICHD, National Institute of Child Health and Development • NICU, neonatal intensive care unit • RCT, randomized, controlled trial • ELBW, extremely low birth weight • VLBW, very low birth weight • CNS, central nervous system • MRI, magnetic resonance imaging • PVL, periventricular leukomalacia • NEC, necrotizing enterocolitis • SES, socioeconomic status • MDI, Mental Development Index • PDI, Psychomotor Developmental Index • BSID-II, Bayley Scales of Infants Development-II • GMFCS, Gross Motor Function Classification System • ADHD, attention-deficit/hyperactivity disorder • NEPSY, Neuropsychological Test • BINS, Bayley Infant Neurodevelopmental Screener • LRO, Language Receptive Organization • LEO, Language Expressive Organization • CPT, Continuous Performance Test • CAT/CLAMS, Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale • TOVO, Test of Variables of Attention • CBCL, Child Behavior Check List • QOL, quality of life • CHQ, Child Health Questionnaire • HRQL, health-related quality of life
Accepted Aug 2, 2004.
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