Mechanisms of Injury from Environmental Exposures in the Neonatal Intensive Care Unit Impacting Neurodevelopmental Outcomes for Neonates

BACKGROUND:Technological advancement in neonatal-perinatal care has improved the survival of critically ill neonates with complex medical and surgical conditions. As part of diagnostic and therapeutic management, these vulnerable neonates are exposed to potential harmful and unintended exposures in the NICU, including diagnostic imaging, sensory environments, medications, nutrition, blood products, and devices. SUMMARY:The negative effects on multiple organs at cellular levels can not only impact the growth, development, and neurocognitive outcomes for the neonate but have the potential of being transmitted to future generations through epigenetic changes. Families, nurses, clinicians, and researchers invested in improving neonatal outcomes need to be aware of these negative impacts. KEY MESSAGE:Concerted efforts should focus on eliminating known toxic and harmful substances from commercial products used in neonatal care, and alternatives should be made available. Generational population health globally from early neonatal period to adulthood can be improved by allocating resources to research and mitigation strategies.