Very preterm babies: Large differences in the use of specialist health services in different European countries

Very preterm babies (born earlier than 32 weeks gestational age) suffer more frequently from various impairments, such as motor, hearing, vision, developmental and cognitive impairments, compared to term babies, and the earlier the baby is born, the higher the risk of facing difficulties. As a matter of fact, of all babies born extremely preterm (22-27 weeks), between 21% and 35% suffer from moderate to severe neurological disability in childhood, and 40% of babies born extremely preterm have a severe health condition when they leave the hospital.

To find out which specialist health services are used primarily by the parents and what the differences are in the use of the specialist health services between European countries, the EPICE (Effective Perinatal Intensive Care in Europe) Research Group of the EU-funded “Screening to improve Health In very Preterm InfantS in Europe” (SHIPS) project analysed perinatal data of 4322 children in 11 European countries. By “special health services” in this context we understand specialist doctors (e.g. ophthalmologist or neurologists) and specialist therapists (e.g. physiotherapists or speech therapists) who can offer follow-up services to monitor impairments and health conditions of preterm children.

Small girl taking hearing test (c) Shutterstock

Here are some of the results:

• Seventy-six percent of the children had consulted at least one specialist, with a range from 53.7% in Italy to 100% in Estonia.

• The specialist health services consulted the most throughout Europe were ophthalmologists (53.4%) and physiotherapists/motor development therapists (48%).

• There were large differences between countries. For example, only 23.9% of Danish very preterm babies went to see an ophthalmologist, while almost all (99.3%) of the very preterm babies in Estonia went to see an ophthalmologist.

• The differences within Europe may be due to different national follow-up policies, different models of care and the accessibility of specialist services. In Estonia, for example, a national follow-up policy is in place.

Specialist health care services use in a European cohort of infants born very preterm
Seppänen AV, Bodeau-Livinec F, Boyle EM, Edstedt-Bonamy AK, Cuttini M, Toome L, Maier RF, Cloet E, Koopman-Esseboom C, Pedersen P, Gadzinowski J, Barros H, Zeitlin J; Effective Perinatal Intensive Care in Europe (EPICE) research group.
Dev Med Child Neurol. 2018 Dec 3. doi: 10.1111/dmcn.14112.