New guidance is spelling out how pediatricians should monitor young children who are at especially high risk for developmental disabilities.
In a clinical report published in the July issue of the journal Pediatrics, the American Academy of Pediatrics is offering up a framework for primary care pediatricians on treating premature infants.
Some 1 in 10 babies are born before 37 weeks gestation and considered premature, leaving them with greater odds of developmental issues, according to the pediatrics group. But, once they leave the neonatal intensive care unit, most of these children rely on general practice pediatricians exclusively.
The guidance, which is based on research over the last 20 years on preterm outcomes, encourages primary care pediatricians to take a more active role in assessing development and in connecting children with both medical and community supports.
“Although a substantial amount of literature addresses severe neurodevelopmental disabilities associated with preterm birth and its complications, such as cerebral palsy, intellectual disability (ID), visual impairment and hearing loss, extrapolating large studies about the risk and clinical decision-making for individual patients can be challenging,” the guidance states. “This clinical report links preterm birth and its complications to early childhood developmental disability prevalence data and consolidates them into an easy-to-use, point-of-care framework that supports pediatricians with enhanced childhood surveillance and clinical decision-making for infants born preterm.”
In the report, the pediatrics group includes a chart detailing the risk for various developmental disabilities for children born at different points as compared to the general pediatric population. For example, it indicates that children born before 32 weeks are considered to be at very high risk of cerebral palsy, while those born at 32 to 37 weeks face moderate-low risk for the condition.
The document provides next steps depending on a child’s circumstances. Using the framework to assess a child’s individual risk level can help pediatricians guide families and determine whether enhanced developmental screening, referrals to early intervention or other steps are warranted, the guidance indicates.
by Michelle Diament | July 14, 2023
Medical student Sarah Bauer checks on a newborn at the neonatal intensive care unit at Loyola University Medical Center in Chicago in 2013. (Antonio Perez/Chicago Tribune/TNS)