While high infant mortality rates were recognized as early as the 1860s, modern neonatal intensive care is a relatively recent advance. It was not until 1965 that the first American newborn intensive care unit (NICU) was opened, and in 1975 the American Board of Pediatrics established sub-board certification for neonatology. The 1960s brought a rapid escalation in neonatal services with the advent of mechanical ventilation of the newborn. This allowed for survival of smaller and smaller newborns. In the 1980s, the development of pulmonary surfactant replacement therapy further improved survival of extremely premature infants and decreased chronic lung disease, one of the complications of mechanical ventilation, among less severely premature survivors. In 2006 newborns as small as 450 grams and as early as 22 weeks gestation have a chance of survival. In modern NICUs, infants weighing 1000 grams and at 27 weeks gestation have an approximately 90% chance of survival and the majority have normal neurological development.
They may also act as general pediatricians, providing well newborn evaluation and care in the hospital where they are based. Some neonatologists, particularly those in academic settings, may follow infants for months or even years after hospital discharge to better assess the long term effects of health problems early in life. Some neonatologists perform clinical and basic science research to further our understanding of this special population of patients.learn more >
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