Semin Fetal Neonatal Med. 2024 Nov 7:101558. doi: 10.1016/j.siny.2024.101558. Online ahead of print.
ABSTRACT
Worldwide polycrises continue to challenge the World Health Organization’s proposed 2030 sustainable development goals. Continuity of brain care bundles helps attain these goals by sustaining brain health over successive generations. Factors representing social drivers of health must incorporate transdisciplinary care into equitable intervention choices. Drivers are more effectively addressed by combining maternal and pediatric assessments to address morbidity and mortality across each lifespan. Care bundles comprise at least three evidenced-based interventions collectively implemented during a clinical experience to achieve a desired outcome. Synergy among stakeholders prioritize communication, responsibility, compliance and trust when choosing bundles in response to changing clinical conditions. A prenatal transdisciplinary model continues after birth with infant and family-centered developmental care practices through discharge to supplement essential skin-to-skin contact. Fetal-neonatal neurology training encourages participation in this model of brain health care to more effectively choose neurodiagnostic and neuroprotective options. Shared clinical decisions evaluate interventions from conception through the first 1000 days. At least eighty percent of brain connectivity will have been completed during this first critical/sensitive period of neuroplasticity. The developmental origins of health and disease concept offers neurology subspecialists a life-course perspective when choosing brain health strategies. Toxic stressor interplay from reproductive and pregnancy diseases and adversities potentially impairs embryonic, fetal and neonatal brain development. Continued exposures throughout maturation and aging worsen outcome risks, particularly during adolescence and reproductive senescence. Intragenerational and transgenerational use of care bundles will guide neuromonitoring and neuroprotection choices that strengthen preventive neurology strategies.
PMID:39537454 | DOI:10.1016/j.siny.2024.101558
