We often read that investing resources into the tiniest of preterm babies may not be cost-effective given the mortality risk as well as the neurodevelopmental disability that can occur in the extremely preterm infant. Yet maybe the more intensive care resources we provide, the better the outcomes? That opinion is substantiated by Serenius et al. (doi:10.1542/peds.2014-2988) as they describe some interesting findings using a national prospective study of more than 800 fetuses alive at the time a mother was admitted for delivery. To our surprise, being proactive and increasing the intensity of perinatal care does result in some pretty impressive risk-reduction in these ELBW infants. So what should we conclude about the use of proactive care in this high risk population of infants.
Doctor Cody Arnold and Doctor Eric Eichenwald weigh in with an accompanying commentary that sheds further light on the findings in this study (doi: 10.1542/peds.2015-0536) Maybe the cost is outweighed by the benefit—but we’d love to know your thoughts about how much is too much when it comes to trying to provide whatever it takes to help an extremely preterm baby?
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