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Preface
Diseases of the Newborn was one of the first books dedicated to the diagnosis and treatment of problems of the neonate. The 1st edition was published in 1960 by Dr. Alexander Schaffer, a well-known Baltimore pediatrician who first coined the terms neonatology and neonatologist. He described neonatology as an emerging pediatric subspecialty concentrating on the “art and science of diagnosis and treatment of disorders of the newborn infant,” and a neonatologist as a “physician whose primary concern lay in that specialty.” Dr. Schaffer served as sole author for both the 1st and 2nd editions (1966) of the book. Dr. Mary Ellen Avery joined Dr. Schaffer as a co-author for the 3rd edition in 1971. Drs. Avery and Schaffer recognized that their book needed multiple contributors with subspecialty expertise as they developed the 4th edition in 1977, and they became co-editors, rather than co-authors. Dr. Schaffer died in 1981 and Dr. H. William Taeusch joined Dr. Avery in 1984 as co-editor for the 5th edition. Dr. Roberta Ballard joined Drs. Taeusch and Avery for the 6th edition in 1991, then titled, Schaffer & Avery’s Diseases of the Newborn. The 7th edition, edited by Drs. Taeusch and Ballard, was published in 1998, and was entitled Avery’s Diseases of the Newborn, in recognition of Dr. Avery’s diligent work on the book through four editions over 20 years. Dr. Christine Gleason joined Drs. Taeusch and Ballard in 2005 as editors for the 8th edition. In 2009, Drs. Avery, Taeusch, and Ballard retired from editing Avery’s, and became “editors emeriti.” Sadly, Dr. Avery passed away in 2011. Her legacy lives on, however, in the title of this book. Dr. Sherin Devaskar joined Dr. Gleason in 2012 as co-editor for the 9th edition—the first edition with accompanying online content. For the 10th edition, Dr. Sandra “Sunny” Juul teamed with Dr. Gleason as co-editor, marking the first time since the 5th edition that all editors were faculty at the same institution. For this new, 11th edition, Dr. Taylor Sawyer, also on the faculty at Dr. Gleason’s institution, joins as co-editor. This edition marks the fourth that Dr. Gleason has co-edited, making her the longest serving editor since Dr. Avery
The 1st edition of Diseases of the Newborn was used mainly for diagnosis, but also included descriptions of early neonatal therapies that had led to a remarkable decrease in the infant mortality rate in the United States: from 47 deaths per 1000 live births in 1940 to 26 per 1000 in 1960. However, a pivotal year for the fledgling subspecialty of neonatology came in 1963, 3 years after the first publication of Diseases of the Newborn, with the birth of President John F. Kennedy’s son, Patrick Bouvier Kennedy. Patrick was a preterm infant, born at 34-35 weeks’ gestation, and his death at 3 days of age from complications of respiratory distress syndrome accelerated the development of infant ventilators, which, coupled with micro-blood gas analysis and the use of umbilical artery catheterization, led to the development of newborn intensive care in the late 1960s
Advances in neonatal surgery and cardiology, along with ongoing technological innovations, stimulated the development of neonatal intensive care units and regionalization of care for sick newborn infants over the next several decades. These developments were accompanied by an explosion of research that improved our understanding of the pathophysiology and genetic basis of diseases of the newborn. This in turn led to spectacular advances in neonatal diagnosis and therapeutics—particularly in the care of preterm infants. Combined, these advances have resulted in significant reductions in infant mortality worldwide: from 6.45% in 1990 to 2.82% in 2019. Current research efforts are focused on decreasing the unacceptable regional, ethnic, and global disparities in infant mortality, improving neonatal long-term outcomes, advancing neonatal therapeutics, preventing newborn diseases, and finally—teaming with our obstetrical colleagues—preventing prematurity. This edition tries—as all prior editions have—to translate the findings of ongoing research into practical advice for use at the bedside by neonatal caregivers.
What’s New and Improved About This Edition?
Perhaps the most significant change to this edition is what was removed rather than what was added. We carefully reviewed the 10th edition’s table of contents, examining each chapter with a keen eye on keeping the book targeted on diseases of the newborn, bringing the content more in line with the original editions. Thus, several chapters that were not specifically disease-focused were archived, while chapters in some sections were subdivided into new chapters focused on disease-specific content. This book continues to be thoroughly (and sometimes painfully) revised and updated by some of the best clinicians and investigators in their fields—several of whom are new contributors. Some chapters required more extensive updates than others. For all chapters, however, we challenged authors to decrease the word count, use boxes, tables, and figures to break up dense text, and to do their best to make the content as disease-focused as appropriate. This resulted in a more concise, readable, and hopefully, clinically helpful text. We are so grateful to our authors for their contributions and hope readers appreciate their work
Do We Still Need Textbooks?
With the incredible amount of information immediately available on the internet, what’s the value of a textbook? We believe that textbooks, such as Avery’s Diseases of the Newborn, will always be needed by clinicians striving to provide state-of-the-art neonatal care, by educators working to train the next generation of caregivers, and by investigators diligently advancing neonatal research and scholarship. A textbook’s content is only as good as its contributors. This book, like in previous editions, has awesome contributors. The authors were chosen for their expertise and ability to integrate their knowledge into a comprehensive, readable, and useful chapter. They did this in the hope that their syntheses could, as Ethel Dunham wrote in the foreword to the 1st edition, “spread more widely what is already known … and make it possible to apply these facts.” We are grateful that the online content of this textbook enjoys increasing popularity. However, we still find printed copies of this and other books lying dog-eared, coffee-stained, annotated, and broken-spined in places where neonatal caregivers congregate. With each subsequent edition, the authors of Diseases of the Newborn help fulfill Dr. Schaffer’s vision of clearing the underbrush from the last frontier of medicine in preparation for its eagerly anticipated crops of saved neonatal lives. Textbooks connect us to the past, bring us up to date on the present, and prepare and excite us for the future. We will always need them, in one form or another. To that end, we have challenged ourselves to meet, and hopefully exceed, that need—for our field, for our colleagues, and for the babies entrusted to our care.
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