Neonatal Critical Care: Looking Toward the Future.

Telemedicine, rapid genomic sequencing (rGS), artificial intelligence (AI), and emerging interventions at the limits of viability are reshaping neonatal critical care and transforming the future of neonatology. Telemedicine is expanding neonatal expertise beyond tertiary centers, improving access and continuity of care through prenatal consultation, tele-resuscitation, virtual rounds, and home monitoring. Advances in rGS are shifting neonatal diagnostics toward earlier, precision-based identification of genetic disease, enabling more individualized treatment and prognostication. AI applications in the neonatal intensive care unit are demonstrating promise in early disease detection, imaging interpretation, predictive analytics, and clinical decision support, with the potential to improve outcomes while reducing clinical burdens. Neonatology continues to consider ethical challenges at the limits of viability. The potential for artificial womb technology raises complex questions regarding fetal status, viability thresholds, and the future implications of ectogenesis prompting the urgent need for evolving ethical frameworks.