The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #74237

Michael Malloy, MD, MS, Department of Pediatrics, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, 409 772-2815, mmalloy@utmb.edu

Advances in the management of newborn infants have lead to significant reductions in neonatal mortality over the last 20 years. Improvements in survival have occurred most notably among the very low birth weight infants (< 1500 grams), with notable improvements in survival over the last 10 years among the extremely low birth weight infant (< 1000 grams). Several technological innovations have made these advances possible and will be reviewed in this session. Among these innovations the introduction of surfactant therapy and advances in ventilation technology have played major roles in improving survival. Advances in nutrition in both enteral and parental techniques have contributed to the immediate survival of the extremely low birth weight infant and hopefully have improved the chance of these small infants to develop as much of their inherited neurological potential as possible. Among term infants as well as preterm infants, perinatal asphyxia remains a major neonatal hazard. Current research into better ways of managing these infants may improve outcomes of this group of infants at high risk for neurodevelopmental disorders. Therapeutic innovation in neonatal intensive care of infants has not, however, produced a definite improvement in outcome in every case. Several of these controversial innovations will be discussed during this session. The amazing success that has come with these technological innovations have brought with them ethical, economic, and social dilemmas that have not been resolved. These future challenges will be highlighted at the conclusion of the session.

Learning Objectives:

• Understand physician decision making protocols surrounding pregnancies with medical problems, and the advantages and disadvantages of intervention vs. expectant management, especially in relation to patient outcomes.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.