American Academy of Pediatrics Proposes Primary Care Framework to Evaluate Preterm Infants for Early Childhood Developmental Risks

Preterm birth and its complications are the leading causes of neonatal illnesses and deaths in the United States. Early identification of neurodevelopmental conditions for children who graduated from the neonatal intensive care unit is critical, according to a new clinical report from the American Academy of Pediatrics (AAP) published in the July 2023 issue of Pediatrics (published online June 26). The report “Primary Care Framework to Monitor Preterm Infants for Neurodevelopmental Outcomes in Early Childhood” encourages primary care pediatricians to take a more critical role in the long-term, timely, and coordinated care needed by high-risk infants during their early childhood years. This includes assessing growth, development, feeding, and behavior; mitigating functional limitations; and determining appropriate medical subspecialty and community level supports. In keeping with the tenets of family-centered care and the medical home, the AAP says the use of ongoing developmental surveillance, coordinated-care, shared decision making, strengths-based guidance, and advocacy for appropriate habilitative or rehabilitative services is essential. Benefits of risk awareness based on history of perinatal conditions can empower pediatricians to prioritize healthy development. Authors of the report say increased awareness coupled with heightened developmental surveillance between routine health supervision or validated screening visits will optimize early identification and referral of at-risk children with signs or symptoms of developmental differences. Lastly, another benefit of linking perinatal risk awareness to neurodevelopmental outcomes is to prompt clinicians to seek additional information when developmental delays exceed anticipated risks. 

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.