Follow-up of high-risk newborn infants

High-risk newborns—such as preterm infants, those with very low birth weight, and those requiring intensive neonatal care—are at increased risk for various health complications. Advances in neonatal medicine have improved survival, but these infants remain vulnerable to conditions affecting growth, neurodevelopment, and sensory functions. Prevention, treatment, and follow-up in outpatient settings of the achieved clinical improvement of these patients are required. 

Key aspects of follow-up include early detection and intervention for bronchopulmonary dysplasia, anemia, rickets, feeding and growth delays, and central nervous system injuries. Sensory impairments such as retinopathy of prematurity and hearing loss require systematic screening and specialist care.

Neurodevelopmental monitoring is essential and should be performed regularly using standardized tools such as the DDST-II, ASQ, and Bayley Scales. Cognitive, motor and behavioural development should be assessed from birth to school age at regular intervals according to the child's development, with early rehabilitation and specialised educational support provided when necessary. The main aim is to prepare the child for learning in a regular environment with their peers.

The follow-up strategy also includes individualized immunization planning, based on gestational age and clinical condition. A structured follow-up plan involving a multidisciplinary team—pediatricians, ophthalmologists, neurologists, and other specialists—is essential for optimal outcomes. Good collaboration between all these medical specialists is a prerequisite for better long-term results.

In conclusion, effective follow-up of high-risk newborns is crucial to minimize long-term morbidity and disability. It requires coordinated efforts, the establishment of clear protocols, and the active involvement of family and caregivers to support healthy development and quality of life.

Dr. Tatyana Itova is a pediatrician and neonatologist with extensive clinical experience in the intensive care and follow-up of high-risk and premature infants. She specializes in neonatal intensive care and long-term developmental support and participates in national programs focused on early intervention and child health. Dr. Tatyana Itova is the head of the Neonatology department at the University Hospital Medica Ruse and teaches at the University of Ruse “Angel Kanchev’’, Bulgaria.