Preterm Surveillance

Day 7–10 of life

Set DOL to evaluate.

Screen for IVH/PVH in infants <32 weeks or <1500 g.

4–6 weeks postnatal age

Set DOL to evaluate.

Detect evolving PVL or post-hemorrhagic ventriculomegaly.

36–40 weeks PMA

Set PMA to evaluate.

Prognostic imaging near term-equivalent age before discharge.

First exam at 31w PMA or 4w chronological — whichever is later

Not screening-eligible by GA/BW criteria.

AAP/AAPOS: GA ≤30w OR BW ≤1500 g (or selected unstable 1500–2000 g).

Within 1 month, prior to discharge

Schedule before discharge.

All NICU infants require AABR (not OAE alone) prior to discharge.

≥24h of age, or prior to discharge

Perform pre-discharge.

Universal newborn screen — perform after 24h of age (or pre-discharge if NICU).

24–48 hours of life

Set DOL.

State NBS — initial sample 24–48h.

~14 days, then ~28 days / discharge

Set DOL.

Preterm/NICU repeat per state protocol (typically 2 weeks, and again at 28 days or discharge).

Begin at 4–6 weeks, repeat q2–4 wks

Not routinely indicated by BW/GA.

<1500 g or <32w: monitor Ca/Phos/Alk Phos for osteopenia of prematurity.

~2 weeks and ~6 weeks of life

Repeat at 2 + 6 weeks.

Preterm infants <32w: repeat thyroid screen at 2 and 6 weeks (delayed TSH rise).

Start by DOL 14–28

Begin once on full feeds.

Preterm <1500 g (or <32w): start enteral iron 2–4 mg/kg/day once feeds established.

From first week of feeds

Start with feeds.

Preterm: 400 IU/day once enteral intake supports (up to 800 IU/day for <1800 g per some protocols).

Weekly while on respiratory support

Trend weekly.

Trend hemoglobin; consider transfusion thresholds or ESA per unit protocol.

Within 1 week of anticipated discharge

Plan within ~1 week of anticipated discharge.

AAP: required for infants born <37w prior to discharge.

Chronological age 60 days

Set DOL.

Give per chronological age (NOT corrected) once 60 days old, regardless of weight.

1 month chronological OR discharge

Defer until 1 month or discharge.

Preterm <2 kg: defer first dose until 1 month chronological or hospital discharge (if HBsAg-negative mother).

Prior to discharge during RSV season

Plan before discharge in season.

Nirsevimab for infants <8 months entering first RSV season; preterm/CLD per AAP guidance.