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September 21, 1994

Individualized Developmental Care: An Emerging New Standard for Neonatal Intensive Care Units?

Author Affiliations

From the Lula O. Lubchenco Center for Perinatal Research, Education, Followup and Epidemiology, University of Colorado Health Sciences Center, Denver.

JAMA. 1994;272(11):890-891. doi:10.1001/jama.1994.03520110070032

Many factors have improved the infant and neonatal mortality in this country. The evolution of nurseries for premature newborns into modern neonatal intensive care units (NICUs) and technological advances used in NICUs have certainly contributed to the reduction in mortality for all birth-weight/gestational-age categories. This reduction in mortality has been most dramatic in recent years for very low-birth-weight (<1500 g) and extremely low-birth-weight (<1000 g) infants. Mortality has traditionally been the tool used to evaluate the success of NICUs with these small infants. However, today both short-term and long-term morbidity and neurodevelopmental outcome must be evaluated when assessing any new intervention used in the NICU.

See also p 853.

The acceptance of new innovations in care in perinatal medicine has an unfortunate history. Unproven therapies or therapies with inappropriate risks have been adopted, while proven therapies remain underused. In the 1940s and 1950s, an epidemic of blindness, due to retinopathy