Preterm Infant Care After Hospital Discharge

The survival of low birth weight infants has been markedly altered by the improvements in neonatal care. Despite these advances, little progress has been made in reducing the incidence of prematurity and low birth weight. Recently available statistics from 1983 indicate that, of all live births, 9.2% were premature (<37 weeks' gestation) and 1.8% were very premature (<32 weeks's gestation). Approximately 6% of infants are born weighing <2,500 g and 1.1% are very low birth weight (<1500 g). Approximately 3.6% of babies born in the United States are both premature and of low birth weight, and 0.8% are VLBW and very premature. Despite these relatively small numbers, this population comprises a disproportionately high percentage of children with medical, neurologic, and developmental problems. It is clear that, as more infants with low birth weights enter the pediatric population, pediatricians must become more expert in managing the medical conditions of these infants, recognizing early signs of neurologic disorders and monitoring their developmental progress. Routine physical examinations are usually not sufficient for such children. More time is generally needed to assess them and to discuss them with their parents than the typical well child. Physicians can play a major role in the identification of problems early in their evolution.