Introduction

As described in Chapters 3 and 4, medical intervention has not succeeded in preventing a substantial fraction of preterm deliveries in the United States. Instead, recent decreases in neonatal mortality reflect the effectiveness of prenatal and neonatal intensive management in improving the survival of ever smaller, more immature infants. The survival of these infants and the quality of life they are able to enjoy has been a critical concern and one that research is only recently beginning to elucidate.

Concerns about the outcomes of these premature survivors have traditionally focused on neurodevelopmental outcomes. Research has emphasized cognitive development as reflected by developmental or intelligence quotients, and/or neuromotor abnormalities, especially cerebral palsy (CP). More recently, a larger array of outcomes has been reported, as will be illustrated in this chapter. With this expansion of scope of concern, the importance of considering a broad array of potential confounders in the relationship between prematurity and various outcomes has been underscored. For example, it cannot be assumed that the factors other than prematurity that may contribute to the risk of poor cognitive development are the same as those that influence social–emotional development.

This chapter discusses the impact of prematurity on physical and developmental outcomes and proposes several options for using current technology to improve the outcomes of premature infants.

Any overview of this outcomes literature should be prefaced by a few caveats.