Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: In their study of the long-term outcomes for extremely low-birth-weight (ELBW) infants, Dr Hack and colleagues1 show that medical advances in perinatal care in the 1990s have decreased mortality, but ELBW children have very high rates of chronic conditions, functional limitations, and special health needs. The authors underscore the importance of providing a medical home and care coordination as part of long-term treatment. In their accompanying editorial, Drs Tyson and Saigal2 describe the increase in the absolute numbers of impaired ELBW survivors as disappointing, and propose approaches for gaining a better understanding of the effects of perinatal treatment decisions and the long-term needs of these children for medical services. I believe that the recommendations for health services and planning by Hack et al do not look far enough into the future, and that Tyson and Saigal’s questions about the long-term needs of these children have, in many important ways, already been answered.
Reiss J. Long-term Outcomes for Extremely Low-Birth-Weight Infants. JAMA. 2005;294(17):2168-2169. doi:10.1001/jama.294.17.2168-b