title: The very low birth weight infant after discharge from intensive care: anticipatory health care and developmental course.
abstract: Despite intensive research, the data available on the long-term effects of prematurity on development of the child have not led to clearcut conclusions, particularly when the investigations are based on infant or perinatal factors alone. Previous research does indicate that the infant is "at risk" through school age and that the parents' perception of the child and the harmony between the child and his environment are powerful determinants of outcome. The implications for medical care, however, are clear. The developing low birth weight infant is best served by close medical supervision, particularly during the turbulent early years. Health care should be planned to include ongoing developmental assessment and screening at least through school entrance so that emerging vulnerabilities or deficits may be addressed as early as possible, thus impeding developmental progress minimally. An optimal care plan includes active partnership with the parents in detection of weaknesses, reinforcement of strengths, and formulation of recommendations for behavioral and educational management. For the physician this will require clinical acumen, an understanding of the child within the context of his environment, an attitude of supportive realism and a long view.
mesh_terms: D002657:Child Development / Q000502:physiology; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000639:trends*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D012306:Risk