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

Journal of Perinatology volume 42, pages 165–168 (2022)Cite this article

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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.

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Authors and Affiliations

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

    Sonika Agarwal

  2. 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

    Mark S. Scher

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  1. Sonika Agarwal
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  2. Mark S. Scher
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Contributions

Dr. Agarwal conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. Dr. Scher conceptualized and designed the study, and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Sonika Agarwal.

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Agarwal, S., Scher, M.S. Fetal-neonatal neurology program development: Continuum of care during the first 1000 days. J Perinatol 42, 165–168 (2022). https://doi.org/10.1038/s41372-021-01282-5

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