Implications of Preterm Birth for Health and Well Being over the Life Course

Life Course Translational Research Network (LCT-RN) Prematurity Node leaders Jonathan Litt and Susan Hintz have co-edited a Special Issue of Children that considers the life-course implications of preterm birth on physical, mental and behavioral health, functional abilities and wellbeing  of children and their families.  This collection of twelve manuscripts explores both the experience of premature birth, and care after birth from a life course perspective, incorporating the reports of parents, family members and professionals from disciplines including psychology, child health, public health, nursing and doula care. 

Explore the Special Issue

While survival rates after premature birth have improved dramatically over the past three decades, outcomes vary by infant and maternal health at birth, experiences during the neonatal hospitalization, and the family and social context in which the child lives. It is this familial and community environment which has not received adequate attention in the literature, yet provides the vital ‘scaffolding’ that will support each child’s subsequent growth and development long after they leave the NICU. The life course health development approach recognizes that children and families exist within a dynamic, multilayered ecosystem of community, social, educational and economic environments that can either pose a threat, or serve to support and optimize children’s health development trajectories. This collection of papers considers new ways to optimize that developmental ecosystem to support optimal outcomes for children and their families.

In the framing article, Jonathan Litt and colleagues explore how applying a Life Course Health Development (LCHD) Approach to care after prematurity could help to ensure optimal outcomes.  The existing system of high-risk infant follow up has a number of shortcomings, including unclear goals, inadequate support for infants, parents and families and an artificially foreshortened time horizon. Mapping life course concepts such as health development, unfolding, complexity, timing, plasticity, thriving and harmony to key components of follow-up care could result in a more effective approach leading to optimal functional outcomes. The impact of prematurity is not limited to the first few years, but rather constitutes an interrelated cascade of vulnerabilities that can pose ongoing challenges to the typical processes of developmental unfolding and opportunities for resilience.  Addressing these issues requires multi-level supports that are responsive to the child’s social and developmental environments, multilevel in scope, and integrated across health, education and social services as well as community-based resources and organizations. 

All Articles

Litt J, Hintz S (eds) The Implications of Preterm Birth for Health and Wellbeing Across the Life Course. Children (ISSN 2227-9067) 2023; 10 (11).

• Litt JS, Halfon N, Msall ME, Russ SA, Hintz SR. Ensuring Optimal Outcomes for Preterm Infants after NICU Discharge: A Life Course Health Development Approach to High-Risk Infant Follow-Up. Children. 2024; 11(2):146. https://doi.org/10.3390/children11020146
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• DiBari JN, Rouse L. Parent Perspectives: Part 1—Considerations for Changing the NICU Culture. Children. 2023; 10(11):1735. https://doi.org/10.3390/children10111735
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• DiBari JN, Rouse L. Parent Perspectives: Part 2—Considerations for the Transition Home Post-NICU Discharge. Children. 2023; 10(12):1835. https://doi.org/10.3390/children10121835
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• Msall ME. Family Reflections on a Lifecourse Journey after Neonatal Intensive Care: Neurodiversity, Enablement and Hope. Children. 2024; 11(2):165. https://doi.org/10.3390/children11020165
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• Gorsky KG, Butala S, House M, Moon C, Calvetti S, Khando T, Kipke M, Lakshmanan A. Uncertainty and the NICU Experience: A Qualitative Evaluation of Family and Provider Perspectives. Children. 2023; 10(11):1745. https://doi.org/10.3390/children10111745
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• Rosenfeld LE, McCullagh K, King CJ, Torres M, Litt JS. Organizational Health Literacy as a Tool for Health Equity: Application in a High-Risk Infant Follow-Up Program. Children. 2023; 10(10):1658. https://doi.org/10.3390/children10101658
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• Church PT, Dahan M, Rule A, Janvier A, Stewart JE, Maypole JS, Fehlings D, Litt JS, Banihani R. NICU Language, Everyday Ethics, and Giving Better News: Optimizing Discussions about Disability with Families. Children. 2024; 11(2):242. https://doi.org/10.3390/children11020242
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• Bourque SL, Williams VN, Scott J, Hwang SS. The Role of Distance from Home to Hospital on Parental Experience in the NICU: A Qualitative Study. Children. 2023; 10(9):1576. https://doi.org/10.3390/children10091576
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• Shaw RJ, Givrad S, Poe C, Loi EC, Hoge MK, Scala M. Neurodevelopmental, Mental Health, and Parenting Issues in Preterm Infants. Children. 2023; 10(9):1565. https://doi.org/10.3390/children10091565
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• Bousquet A, Sanderson K, O’Shea TM, Fry RC. Accelerated Aging and the Life Course of Individuals Born Preterm. Children. 2023; 10(10):1683. https://doi.org/10.3390/children10101683
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• Fraiman YS, Guyol G, Acevedo-Garcia D, Beck AF, Burris H, Coker TR, Tiemeier H. A Narrative Review of the Association between Prematurity and Attention-Deficit/Hyperactivity Disorder and Accompanying Inequities across the Life-Course. Children. 2023; 10(10):1637. https://doi.org/10.3390/children10101637
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• Nelin TD, Scott KA, Just AC, Burris HH. Place-Based Strategies Addressing Neighborhood Environments to Improve Perinatal and Preterm Infant Outcomes. Children. 2023; 10(10):1646. https://doi.org/10.3390/children10101646

Disclaimer

This Special Issue was supported in part by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under award UA6MC32492, the Life Course Intervention Research Network, and award U9DMC49250, The Life Course Translational Research Network. The information, content and/or conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.