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November 28, 1990

Individualized Care, as Well as Intensive Care, May Reduce Morbidity Among Premature Infants

JAMA. 1990;264(20):2611-2614. doi:10.1001/jama.1990.03450200017003

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A NEONATAL intensive care unit is nothing like a womb. But perhaps it should be. Some investigators wonder if the stress of such a noisy, bright environment is contributing to the morbidity of premature infants.

Great strides have been made over the last decade in improving survival of low—birth-weight infants. For those infants who weigh 750 to 999 g, survival has increased from 50% to 82%; for those infants who weigh 500 to 750 g, survival has increased from 11% to 36%. And, with the recent licensing of surfactant, it is likely that these figures will continue to improve.

What Price Survival?  This good news is offset in part by concern about the health of the survivors. Studies of older "ex-premies" suggest that they have motor deficits, learning disorders, and behavioral and attention problems.In one study by Mary Bozynski, MD, a neonatologist at the University of Michigan, Ann Arbor,