Rebage V, Ruiz-Escusol S, Fernández-Vallejo M, Montejo-Gañán I, García-Iñiguez J P, Galve-Pradel Z, Marco-Tello A, Peña-Segura J L, López-Pisón J
Unidad Neonatal, Hospital Infantil Universitario Miguel Servet, Zaragoza, España.
Rev Neurol. 2008;47 Suppl 1:S1-13.
The progress made in perinatal health care in recent years has changed the epidemiology of neurological diseases during the neonatal period. The reduction in neonatal mortality has been accompanied by an increasingly large number of patients suffering from disabling diseases or with a risk of suffering from them; a prolonged follow-up and the joint efforts of neonatologists and neuropaediatricians are therefore essential.
We review the welfare work and demand for health care for newborn infants with neurological disorders in our service, as well as perinatal neurological morbidity, the functioning of the follow-up outpatients department, and we also report some of the findings from our experience in following up high-risk newborn infants.
The demand for neonatal health care is increasing, and it is important to take this into account so as to be able to plan better strategies for the use of health care resources and for caring for patients. In our population, preterm delivery and asphyxia are the chief perinatal factors leaving neurological sequelae, with an overall incidence that is similar to that reported in other research and a high proportion of severe sequelae. The follow-up programmes must be made cost-effective by better selection of the high risk population to be monitored and coordination with primary care paediatricians. Early detection of the deficits is essential to be able to implement early intervention, and this can be aided by a series of recommendations aimed at professionals and relatives, as well as by improved coordination between the different multidisciplinary groups involved in prevention and care programmes.
近年来围产期保健取得的进展改变了新生儿期神经系统疾病的流行病学。新生儿死亡率的降低伴随着越来越多患有致残性疾病或有患此类疾病风险的患者；因此，延长随访以及新生儿科医生和神经儿科医生的共同努力至关重要。
我们回顾了我们服务中对患有神经系统疾病的新生儿的福利工作和医疗保健需求，以及围产期神经疾病发病率、随访门诊的运作情况，并且我们还报告了我们在随访高危新生儿方面的一些经验发现。
对新生儿保健的需求在增加，考虑到这一点很重要，以便能够制定更好的医疗保健资源使用和患者护理策略。在我们的人群中，早产和窒息是导致神经后遗症的主要围产期因素，总体发病率与其他研究报告的相似，且严重后遗症比例较高。必须通过更好地选择要监测的高危人群并与基层儿科医生协调，使随访计划具有成本效益。早期发现缺陷对于能够实施早期干预至关重要，这可以通过针对专业人员和亲属的一系列建议以及改善参与预防和护理计划的不同多学科团队之间的协调来实现。
