The Medically Complex Premature Infant in Primary Care

The survival rate of the smallest and youngest of premature infants has continued to improve as medical technology has progressed. The current edge of viability is represented by infants born at 23 to 25 weeks’ gestation. Neonatal survival of infants at 23 weeks’ gestation ranges from 11% to 30%. Survival to hospital discharge for infants ranging from 23 to 26 weeks’ gestation is about 70%; 30% to 50% of these infants have moderate to severe disability. Nurse practitioners and physicians will be meeting these young infants in primary care offices after they have been discharged from the neonatal intensive care unit. This article is Part III in a series addressing issues related to the premature infant. This installment focuses on medically complex premature infants and their health issues after discharge. Part I addressed issues common to all premature infants. Part II looked at the healthy premature infant and their management in primary care.