NEONATOLOGY: EVOLUTION FROM THE PAST TO FUTURE PERSPECTIVES

The begin of modern neonatology takes place in the 1940s, when physicians first started to have interest in the newborn so that the primary responsibility for the neonate passed from the obstetricians to the neonatologists. In the 19th century the term premature grouped together the concept of “preterm and weak infants”, meant as babies suffering from poor energy and vitality. The idea that premature infants could be treated was introduced in the second half of the 19th century, when crucial fields signed the basis for neonatal care over the last century, such as thermoregulation, Apgar score, respiratory support, prenatal corticosteroids, metabolic screening and jaundice. From then on, advances in neonatology have resulted in the reduction of infant mortality worldwide. To date, scientific evidences have shown that the environmental conditions experienced in early life can profoundly influence human biology and long-term health. Chemical contaminants in water and diet, tobacco smoke, air pollution, gestational diabetes, hypertension and pre-eclampsia are all conditions that lead to the lowest common denominator oxidative stress. Fetuses and newborns -especially preterm- are particularly susceptible to oxidative stress mediated damage. Recently, the “omics” sciences represent the major area of growing interest and research in neonatology. The analysis of the metabolic profile detectable in a human biological fluid allows to instantly identifying changes in the composition of endogenous and exogenous metabolites caused by the interaction between specific physiopathological states, gene expression, and environment. From metabolomics studies comes the need of individualized and tailored medicine.