Table 2.

Considerations for clinicians offering intensive care for infants ≤ 23 weeks

How do neonatologists and obstetricians collaborate in the care of the maternal-child dyad? Are decisions about antenatal corticosteroids and c-section considered separately?

How do healthcare providers communicate and collaborate with parents and caregivers? Are mechanisms for shared decision-making and ongoing communication in place?

Is appropriately sized equipment available for respiratory support and intravenous access?

Do all team members in the neonatal intensive care unit (e.g.,physicians, nurse practitioners, nurses, respiratory therapists, nutritionists, and others) agree that intensive care for such immature infants is not futile?

Do clinicians recognize the unique physiological challenges and vulnerabilities of infants ≤23 weeks—that they are not just smaller preterm infants?

Is multidisciplinary long-term follow-up in place to provide support for these vulnerable patients after they are discharged from the hospital?

Are outcomes tracked, benchmarked, and monitored to identify areas for improvement in this nascent area of practice?