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The care of prematurely born child: when to begin and end?


Authors: D. Marková 1;  M. Weberová-Chvílová 1;  P. Raušová 1;  E. Knězů 1;  P. Klement 1;  B. Korsová 1;  I. Příhodová 1;  E. Koštálová 1;  V. Kredba 1;  J. Langer 1;  P. Frühauf 1;  J. Kytnarová 1;  P. Koťátko 1;  J. Šulc 1;  L. Vepřeková 1;  P. Uhlíková 1;  P. Jánská 1;  R. Vyhnánek 1;  B. Zlatohlávková 2;  A. Fleischnerová 1;  R. Ptáček 1;  D. Mirovská 1;  L. Smolíková 1;  E. Haškovcová 1;  J. Mercelová 3;  R. Kunzmanová 1;  J. Zeman 1
Authors‘ workplace: Klinika dětského a dorostového lékařství UK 1. LF a VFN, Centrum komplexní péče pro děti s perinatální zátěží, Prahapřednosta prof. MUD. J. Zeman, DrSc. 1;  Neonatologické oddělení, Gynekologicko-porodnická klinika UK 1. LF a VFN, Prahaprimář prof. MUDr. R. Plavka, CSc. 2;  Foniatrická klinika VFN, Prahapřednostka doc. MUDr. O. Dlouhá, CSc. 3
Published in: Čes-slov Pediat 2014; 69 (1): 53-62.
Category: Actual Topic

Overview

Over the last twenty years, neonatal mortality in the Czech Republic declined significantly to current 1.38 per 1 000 born alive. As a result, increasing number of babies surviving early neonatal period has been repeatedly reported. Despite significant improvement in neonatal intensive care, many babies are however suffering from serious perinatal morbidity, particularly those with extremely low birth weight.

The recent data show that out of 107 213 children born alive in the Czech Republic in 2012, 8 897 of them were reported preterm, which represent 8.3 %. As consequence, there is constantly increasing demand for further clinical investigation, treatment and long term follow up of these children. Centralised multidisciplinary collaborative approach developed in our unit may offer unique approach to improve long term outcome of these children. Further decline in morbidity translates into better socialisation and mitigates negative impact on entire family.

Historically, the outcome measures of success of treatment of prematurely born babies were mortality and short term morbidity. Nowadays, it becomes obvious that not only short term but particularly long term follow up provides optimal medical care to ex-preterm children and their families. Detailed long term observational studies provided by centralised approach on associated co-morbidity, future neurodevelopmental and psychosocial behaviour including education abilities will help better understand of natural history and may serve for future medical management and medical care planning in the Czech Republic and beyond.

Key words:


prematurity, low birth weight infant, long term morbidity, long term follow up, developmental disorders, multidisciplinary collaboration


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Labels
Neonatology Paediatrics General practitioner for children and adolescents
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