Long-term consequences of prematurity

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TABLE 1

Effects of prematurity on organ systems, and management recommendations

Organ system	Increased risks	Management
Pulmonary	Obstructive disease, pulmonary hypertension	Evaluate previous asthma diagnosis Consider baseline pulmonary function testing Avoid smoking, maintain healthy weight, promote exercise Keep current on influenza and Pneumococcus vaccinations
Renal	Chronic kidney disease	Monitor blood pressure regularly Avoid nephrotoxins Control blood pressure (consider an angiotensin-converting enzyme inhibitor if a hypertension medication is needed) Limit salt intake Consider periodic urine microalbumin screening, renal ultrasonography
Cardiovascular	Hypertension, ischemic heart disease, congestive heart failure, peripheral vascular disease	Monitor blood pressure regularly Avoid smoking, maintain healthy weight, promote exercise Consider baseline echocardiogram with appropriate cardiovascular risk assessment
Endocrine	Diabetes, metabolic syndrome, obesity, osteoporosis	Monitor blood glucose, body mass composition, lipids Maintain healthy body weight and abdominal girth Ensure appropriate calcium and vitamin D supplementation Promote weight-bearing exercise Limit medications associated with causing metabolic abnormalities, dyslipidemia, worsening bone density
Central nervous system	Autism, mood disorders, intellectual disabilities	Be alert to need for early evaluation and support