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Objectives
After completing this article, readers should be able to:
Describe changes over time in the characteristics of study subjects in neonatal follow-up studies.
Describe changes over time in the outcome assessments of neonatal follow-up studies.
Delineate four broad research themes of neonatal follow-up studies.
Summarize the evolution of studies of the prevalence of disability and contributing causes of developmental impairments in preterm infants.
Summarize the evolution of studies of severely ill term and near-term infants.
Introduction
Within a few years of the opening of the first preterm infant nursery in the United States in 1922, reports appeared describing the long-term outcomes of treated infants. Early studies of health and developmental outcome described the frequency of impairments for specific groups of high-risk neonates. More recently, neonatal follow-up studies have been used to evaluate the effectiveness of therapeutic interventions and to test specific hypotheses about the etiology of an impairment.
The outcome of interest in neonatal follow-up studies is the health or development, beyond the first months of life, of high-risk neonates. In observational follow-up studies, risk factors of interest have included biologic (eg, perinatally acquired brain damage), environmental (eg, maternal depression), and “established” risk factors (eg, cytomegalovirus infection, genetic syndromes).
Table 1⇓ summarizes changes in research methods in follow-up studies during the 20th century Based on epidemiologic principles, Kiely and Paneth offered the following suggestions for improving neonatal follow-up studies: 1) use of population-based rather than hospital-based samples for prevalence studies; 2) inclusion of appropriate controls; 3) assessment of confounding due to social class; and 4) minimizing lost-to-follow-up rates. In addition, they commented on issues specific to neonatal follow-up, including: 1) continued follow-up of subjects to school age; 2) reporting of mortality rates as well as morbidity; 3) reporting of birthweight-specific data; and 4) more detailed reporting of the co-occurrence of …
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