Fetal-neonatal neurology program development: Continuum of care during the first 1000 days.
Sonika AgarwalMark S ScherPublished in: Journal of perinatology : official journal of the California Perinatal Association (2021)
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.
Keyphrases
- healthcare
- quality improvement
- public health
- mental health
- palliative care
- health information
- pregnancy outcomes
- risk factors
- coronary artery disease
- multiple sclerosis
- primary care
- birth weight
- dna methylation
- gestational age
- gene expression
- risk assessment
- cardiovascular events
- genome wide
- pain management
- weight loss
- general practice
- genome wide analysis