Focus on Prematurity: Applying Research to Intervention

Article excerpt

While all parents wonder what the future holds for their newborn babies, parents of premature infants, who often begin life with some "medical complications," are often faced with very specific, complex concerns about the future for their baby (or babies, in the case of multiple births). Initially, both parents and professionals want to know whether a baby will survive, what interventions will be required, and how long-term growth and development will proceed. Unfortunately, even with advanced, sophisticated diagnostic instruments and tests, the medical team cannot make specific predictions about outcomes for many premature infants.

Because the use of today's technology results in, at best, imprecise predictions of a baby's future development, families and physicians must make important life decisions with considerable uncertainty. Physicians attempt to identify "risk factors" - physical symptoms which, in general, seem related to future development difficulties - however, the presence of one or more "risk factors" in any given baby does not allow the medical team to make specific predictions about that child's future with confidence.

Cranial ultrasound: High tech

with limitations

Cranial ultrasound (CLD) examinations, which are often performed during a premature baby's first day of life, provide a way to determine the presence of brain injuries or abnormalities. CU examinations, which look "inside" a baby's brain, can identify certain abnormalities more accurately than examinations based on observations of the baby from the "outside." Because this technology is a major advance in the diagnostic process, many parents and professionals have high expectations about its ability to help doctors make accurate predictions. However, CU abnormalities statistically associated with abnormal outcomes may not prove to be valid predictors for individual children. For example, a child with moderate CU abnormalities may develop normally, while another infant with only mild CU abnormalities may not develop normally. …

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