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- Title
Ensuring Optimal Outcomes for Preterm Infants after NICU Discharge: A Life Course Health Development Approach to High-Risk Infant Follow-Up.
- Authors
Litt, Jonathan S.; Halfon, Neal; Msall, Michael E.; Russ, Shirley Ann; Hintz, Susan R.
- Abstract
Children born prematurely (<37 weeks' gestation) have an increased risk for chronic health problems and developmental challenges compared to their term-born peers. The threats to health and development posed by prematurity, the unintended effects of life-sustaining neonatal intensive care, the associated neonatal morbidities, and the profound stressors to families affect well-being during infancy, childhood, adolescence, and beyond. Specialized clinical programs provide medical and developmental follow-up care for preterm infants after hospital discharge. High-risk infant follow-up, like most post-discharge health services, has many shortcomings, including unclear goals, inadequate support for infants, parents, and families, fragmented service provisions, poor coordination among providers, and an artificially foreshortened time horizon. There are well-documented inequities in care access and delivery. We propose applying a life course health development framework to clinical follow-up for children born prematurely that is contextually appropriate, developmentally responsive, and equitably deployed. The concepts of health development, unfolding, complexity, timing, plasticity, thriving, and harmony can be mapped to key components of follow-up care delivery to address pressing health challenges. This new approach envisions a more effective version of clinical follow-up to support the best possible functional outcomes and the opportunity for every premature infant to thrive within their family and community environments over their life course.
- Subjects
EVALUATION of medical care; WELL-being; NEURODIVERSITY; NEONATAL intensive care; LIFE course approach; HEALTH services accessibility; PREMATURE infants; NEONATAL intensive care units; MEDICAL care; PHYSIOLOGICAL adaptation; AT-risk people; HEALTH behavior; HEALTH equity
- Publication
Children, 2024, Vol 11, Issue 2, p146
- ISSN
2227-9067
- Publication type
Article
- DOI
10.3390/children11020146