Comprehensive management of an extremely premature infant with a burdened history in a children’s outpatient clinic

Premature birth is associated with signs of morphofunctional immaturity, indicating that the newborn is not prepared for extrauterine life. Adaptation is an integrated response of all organs and systems of the body, requiring time and case follow-up by both the attending pediatrician and other healthcare professionals. Given the increasing prevalence of premature birth, this issue remains relevant for obstetricians, neonatologists, and pediatricians, as well as general practitioners and specialist physicians.

This paper presents a clinical case of interdisciplinary management of an extremely premature girl in a children's outpatient clinic. The girl was born at 28 weeks of gestation in a secondary maternity hospital, with a burdened medical and social history. This work addresses progressive developmental care in an extremely premature infant and provides practical recommendations and a case follow-up strategy for such patients in a children’s outpatient clinic. First and foremost, this requires regular examinations by the attending pediatrician, considering the specifics of physical and neuropsychological development of premature infants. Furthermore, case follow-up by specialist physicians in each therapeutic area of concern is required, with mandatory catamnestic follow-up until the age of 3 years to minimize the risk of chronic disorders and prevent disability. Moreover, the strategy provides for continuous monitoring of laboratory and imaging findings (abdominal, kidney, heart, and pelvic ultrasound, neurosonography, and electrocardiography). The timing is determined on a case-by-case basis (every three months or more frequently). Hearing screening requires special attention; it should be performed routinely, every six months, until the age of 3 years, to prevent hearing loss.