Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Special Feature
  • Published:

Neonatal – Perinatal Medicine Fellowship Training in Long-Term Outcomes of Neonatal Intensive Care Unit Graduates

Journal of Perinatology volume 25, pages 423–425 (2005)Cite this article

Education of neonatal – perinatal medicine (NPM) fellows on long-term outcomes is a long-standing tradition that reflects concerns for the long-term quality of life in infants who require neonatal intensive care. Early neonatologists witnessed an unprecedented decline in mortality among newborn infants that accompanied the development of neonatology as a specialty.1 Enthusiasm for new therapies was soon tempered by the realization that new therapies may have unintended long-term consequences.2 Furthermore, although survival is the main outcome of interest to families and society, William Silverman, one of the pioneering neonatologists, noted that survival itself is associated with “innumerable value-defined qualities. In addition to short-term considerations, there are long-term effects of medical interventions that must be taken into account.”3 Subsequent generations of neonatologists have evaluated the long-term effects of medical interventions and described later difficulties with health, growth and neurodevelopmental function in neonatal intensive care unit (NICU) graduates.4, 5, 6, 7 More recently, it has been shown that long-term outcomes are a function of infants' biological risk factors, the practice of neonatal intensive care itself, and the influences of family and the community after discharge.2, 8, 9, 10 Because of the high-risk developmental status of many infants and the vulnerable nature of the developing brain, neonatal educators must pass on to new generations this special responsibility to understand and investigate the outcomes of NICU graduates. Education about these long-term outcomes is therefore a very important part of a neonatal – perinatal medicine fellowship training program.

To meet this educational need, the Accreditation Council for Graduate Medical Education (ACGME) developed requirements that focus on outpatient clinic experiences.11 The current ACGME requirements for NPM fellowship training state that “each resident must participate in the longitudinal follow-up of high-risk neonates.” Furthermore, “a sufficient number of discharged infants must be available in a continuity clinic to assure appropriate outpatient experience for each resident.” Lastly, the requirement states that “these experiences should enable residents to become skilled in longitudinal follow-up, evaluation, and management of such patients, and to become aware of the socioeconomic impact and the psychosocial stress that such infants may place on a family.”

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Guyer B, Martin JA, MacDorman MF, Anderson RN, Strobino DM . Annual summary of vital statistics — 1996. Pediatrics 1997;100:905–918.

    Article  CAS  Google Scholar 

  2. Silverman WA . A cautionary tale about supplemental oxygen: the albatross of neonatal medicine. Pediatrics 2004;113:394–396.

    Article  Google Scholar 

  3. Silverman WA . Human Experimentation: A Guided Step Into the Unknown. Oxford: Oxford University Press; 1985. p. 88.

    Google Scholar 

  4. Allen MC . Risk assessment and neurodevelopmental outcomes In: Taeusch HW, Ballard RA, Gleason CA editors. Avery's Diseases of the Newborn. 8th ed Philadelphia: Elsevier; 2005. p. 1026–1042.

    Chapter  Google Scholar 

  5. Gray JE, McCormick MC, Richardson DK, Ringer S . Normal birth weight intensive care unit survivors: outcome assessment. Pediatrics 1996;97:832–838.

    CAS  PubMed  Google Scholar 

  6. Hack M, Schluchter M, Cartar L, Rahman M, Cuttler L, Borawski E . Growth of very-low-birth-weight infants to age 20 years. Pediatrics 2003;112:e30–e38.

    Article  Google Scholar 

  7. Petrou S, Mehta Z, Hockley C, Cook-Mozaffari P, Henderson J, Goldacre M . The impact of preterm birth on hospital inpatient admissions and costs during the first 5 years of life. Pediatrics 2003;112:1290–1297.

    Article  Google Scholar 

  8. Lucas A, Morley R, Cole TJ, Lister G, Leeson-Payne C . Breast milk and subsequent intelligence quotient in children born preterm. Lancet 1992;339:261–264.

    Article  CAS  Google Scholar 

  9. O'Shea TM, Kothadia JM, Klinepeter KL, et al. Randomized placebo-controlled trial of a 42-day tapering course of dexamethasone to reduce the duration of ventilator dependency in very low-birth-weight infants: outcome of study participants at 1-year adjusted age. Pediatrics 1999;104:15–21.

    Article  CAS  Google Scholar 

  10. Vohr BW, Linda L, Hack M, Aylward G, Hirtz D . Follow-up care of high-risk infants. Pediatrics (Suppl.) 2004;114:1377–1397.

    Google Scholar 

  11. Accreditation Council for Graduate Medical Education. Program Requirements for Residency Education in Neonatal – Perinatal Medicine. 1999 Available from URL: http://www.acgme.org.

  12. Vohr BR, Wright LL, Dusick AM, et al. for the Neonatal Research Network. Center differences and outcomes of extremely low-birth-weight infants. Pediatrics 2004;113:781–789.

    Article  Google Scholar 

Download references

Acknowledgements

We thank Dr. Maureen Hack for her review of the panel's recommendations.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Raye-Ann deRegnier MD

  2. Department of Pediatrics, University of Pennsylvania Health System, Philadelphia, PA, USA

    Roberta Ballard MD

  3. Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, USA

    T Michael O'Shea MD, MPH

  4. Department of Pediatrics, University of California, San Francisco, CA, USA

    Robert Piecuch MD

  5. Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA

    Michele Walsh MD

  6. Department of Pediatrics, Vanderbilt University Medical Center, Nashrille, TN, USA

    Judy L Aschner MD

Authors
  1. Raye-Ann deRegnier MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roberta Ballard MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T Michael O'Shea MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert Piecuch MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michele Walsh MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Judy L Aschner MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

deRegnier, RA., Ballard, R., O'Shea, T. et al. Neonatal – Perinatal Medicine Fellowship Training in Long-Term Outcomes of Neonatal Intensive Care Unit Graduates. J Perinatol 25, 423–425 (2005). https://doi.org/10.1038/sj.jp.7211331

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7211331

This article is cited by

Search

Advanced search

Quick links