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胎儿-新生儿神经学项目发展:生命最初1000天的连续护理

Fetal-neonatal neurology program development: Continuum of care during the first 1000 days.

作者信息

Agarwal Sonika, Scher Mark S

机构信息

Division of Neurology, Assistant Professor, University of Pennsylvania, Children's Hospital of Philadelphia, 3500 Civic Center Blvd., Philadelphia, PA, 19104, USA.

Emeritus Full Professor of Pediatrics and Neurology, Rainbow Babies and Children's Hospital/MacDonald Hospital for Women, University Hospitals Cleveland Medical Center, Case Western Reserve University, School of Medicine, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.

出版信息

J Perinatol. 2022 Feb;42(2):165-168. doi: 10.1038/s41372-021-01282-5. Epub 2021 Nov 30.

Abstract

Global estimates show that 10-20% of persons express developmental disability. During critical and sensitive periods of developmental neuroplasticity over the first 1000 days, adverse gene-environment interactions are likely to contribute to permanent life-long disabilities and early mortality. This article describes fetal-neonatal neurology (FNN) program development that integrates vertical and horizontal diagnostic perspectives. Trimester-specific conditions to the maternal-placental-fetal triad begin at conception, followed by pediatric patient care over the first two years of life to address changing phenotypic form and function. While fetal and neonatal neurology trainees prepare to offer person-centric healthcare, population-based considerations address obstacles to optimal health relevant to resource-rich and poor nations. Maternal and pediatric care practices over the first 1000 days underscore equitable health policy. Global initiatives apply geographic distance, biosocial dynamics, and cultural differences to developmental origins and life-course theories, to more effectively reduce disease burden over the life continuum.

摘要

全球估计表明,10%至20%的人存在发育障碍。在生命最初1000天的发育神经可塑性关键和敏感时期,不良的基因-环境相互作用很可能导致终身残疾和过早死亡。本文介绍了整合纵向和横向诊断视角的胎儿-新生儿神经病学(FNN)项目的发展。针对母-胎盘-胎儿三联体的孕 trimester 特异性病症始于受孕,随后是对出生后头两年儿科患者的护理,以应对不断变化的表型形式和功能。虽然胎儿和新生儿神经病学培训人员准备提供以患者为中心的医疗保健,但基于人群的考虑解决了与资源丰富和贫困国家相关的最佳健康障碍。生命最初1000天的母婴护理实践强调了公平的健康政策。全球倡议将地理距离、生物社会动态和文化差异应用于发育起源和生命历程理论,以更有效地减轻整个生命连续体中的疾病负担。

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