A review of the Rationale for the Existence of Perinatal Follow-up Programs
Advances in perinatal care have traditionally been monitored by changes in the perinatal mortality rate, however, such improvements in care are less likely to be reflected in reductions in perinatal mortality because of the current very low rate of perinatal mortality in Canada. Thus more sensitive tools must be used to identify improvements (or possibly even declines) in the quality of perinatal care. Monitoring rates of cerebral palsy, cognitive impairments, sensory impairments and others impairments have become accepted as tools to monitor outcomes in high-risk infants. Other adverse health outcomes such as poor growth, gastroesophageal reflux disorder, hypertension, etc also require follow-up. The existence of perinatal follow-up programs are essential to ensure a systematic collection and subsequent review of such information.
It is possible to identify several high-risk infants that could be followed. Two overlapping groups, the very low birth weight infant and the very preterm infants are amongst the most commonly followed high-risk infants. Additional groups identified by the Seventh Canadian Ross Conference in Paediatrics  include: a) birth weight 1500-2500 grams with periventricular leukomalacia, b) small for gestational age infants < 37 weeks, c) cord arterial buffer base < 30 mmol/L, d) asphyxia neonatorum in term infants with decreased density on cerebral imaging studies, e) persisting neurologic signs after one week, f) neonatal meningitis and g) hypoglycemia with seizures. Other conditions that could legitimately be followed include multiple births, cardiac anomalies (particularly those undergoing open heart procedures), products of assisted reproductive technology, congenital infections and neonatal stroke.