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Marie C. McCormick, MD, ScD

JAMA. 1989;261(12):1767-1772.

Abstract
A recent review of 20 years' experience with neonatal intensive care for very-low-birth-weight infants provides reassurance that such care saves lives and that an increasing proportion survive free of moderate to severe handicap. However, data on the health status of these survivors largely reflect status in infancy. An increasing literature suggests that such early findings may be insufficient to characterize later outcomes, particularly those problems encountered as the child enters school. Since the specific health and developmental problems that might be encountered are still being defined, a broad conceptual framework is applied to organize a review of the existing literature. Some areas of concern about longer-term outcomes emerge, as well as important areas for which data are lacking. Further definition of longer-term outcomes is critical at the policy level to assess the utility of neonatal intensive care unit interventions and at the individual level for counseling families as to the health and educational needs of these children.

(JAMA. 1989;261:1767-1772)

Author Affiliations
From the Joint Program in Neonatology, and Department of Pediatrics, Harvard Medical School, Boston, Mass.

Footnotes
A preliminary version of this article was presented on May 5,1988, at a conference on the Care of Low Birth-weight Infants in the Neonatal Intensive Care Unit, for the Forum of the Council on Health Care Technology of the Institute of Medicine, National Academy of Science, Washington, DC.

Reprint requests to Joint Program in Neonatology, Brigham and Women's Hospital, 75 Francis St, Boston, MA02115(Dr McCormick).

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