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Systematic review and meta-analysis
37% of child survivors of intrauterine or neonatal insults experience at least one long-term sequela, the most common being neurodevelopmental delay
  1. Anna Maria Marconi
  1. Department of Obstetrics and Gynecology, San Paolo Hospital Medical School, University of Milano, Milano, Italy
  1. Correspondence to: Anna Maria Marconi
    Department of Obstetrics and Gynecology, San Paolo Hospital Medical School, University of Milano, Via A di Rudinì 8, Milano 20142, Italy; annamaria.marconi{at}unimi.it

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Commentary on: Mwaniki MK, Atieno M, Lawn JE, et al. Long-term neurodevelopmental outcomes after intrauterine and neonatal insults: a systematic review. Lancet 2012;379:445–52.

Implications for practice and research

  • Neonates who survive major insults in the neonatal period may suffer varying degrees of long-term neurodevelopmental impairment.

  • Most insults might be prevented through primary and secondary measures such as antenatal steroid administration, use of oxygen to reduce the severity of sequelae, maternal immunisation and early detection to prevent/reduce congenital infections.

  • Rehabilitation programmes for survivors should be improved by creating centres to encourage family members to participate in all aspects of care.

Context

More than 40% of mortality in children younger than 5 years occurs in the neonatal period (0–28 days), and the common causes include preterm birth complications, intrapartum-related factors, acquired infections and other conditions such as jaundice and congenital infections.1 ,2 Intrauterine and neonatal insults contribute to both premature …

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