Journal Article

Follow-up after very preterm birth in Europe

Jarreau, PH, van Heijst, Arno F J, El Rafei, R, Petrou, Stavros, Toome, Liis, Lebeer, J, Pfeil, JM, Zeitlin, Jennifer, Bruneel, E, Seppänen, AV, Kim, Sung Wook, Zemlin, M, Misselwitz, B, Sarrechia, I, Montgomery, A, Zeitlin, J, Petrou, S, Maier, Rolf F, Varendi, H, Barros, H, Lebeer, Jo, Johnson, SJ, Pedersen, Pernille, Gadzinowski, Janusz, Barros, Henrique, Kim, SW, Pikuła, T, Mader, S, Wohlers, L, Maier, RF, Seppänen, Anna-Veera, Cloet, E, Toome, L, Cuttini, M, Costa, R, van Heijst, A, Ferrari, F, Thiele, N, Gadzinowski, J, Nuytten, A, Carnielli, V, Ancel, PY, Andronis, L, Pedersen, P, Pierrat, V, Mazela, J, Draper, ES, Burguet, A, Bonnet, C, Koopman-Esseboom, C, Aubert, A M, Ådén, Ulrika, Cuttini, Marina, Draper, Elizabeth S, Andronis, Lazaros, Van Reempts, P, Ancora, G, Männamaa, M, Croci, I, Aden, U, Oostra, A, Fenton, A, Ortibus, E, Faldella, G, Rodrigues, C, Boerch, K

2022

Overview

Correspondence to Anna-Veera Seppänen, Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, F-75004 Paris, France; [e-mail] Follow-up programmes aim to detect neurodevelopmental and health problems and enable early interventions for children born very preterm (<32 weeks of gestational age (GA)). The data were collected for the Effective Perinatal Intensive care in Europe and Screening to Improve Health in Very Preterm Infants studies, which constituted and followed up an area-based cohort of children born very preterm in 2011/2012 in 19 regions across 11 European countries.4 Perinatal data were collected from obstetric and neonatal records, and parents completed questionnaires at 2 and 5 years of age. Adjustments for social and perinatal characteristics failed to explain differences between countries.Table 1 Family sociodemographic and perinatal factors associated with routine follow-up for children born very preterm, at 5 years of age Does child have routine check-ups for children born very preterm at 5 years? N No, never Not anymore Yes, still Reference: still in follow-up at 5 years No, never Not anymore % % % aRRR 95% CI aRRR 95% CI Mother’s age at delivery (years)  ≤24 422 17.3 55.2 27.5 2.0 1.2 to 3.5 1.1 0.8 to 1.6  25–34 2057 9.2 63.0 27.8 ref ref  ≥35 1098 6.8 67.2 26.0 0.7 0.5 to 1.2 1.0 0.8 to 1.3 Parity at delivery  Multiparous 2156 8.3 63.6 28.1 ref ref  Nulliparous 1390 11.2 62.7 26.1 1.1 0.7 to 1.6 1.0 0.8 to 1.2 Multiple birth  No (singleton) 2531 10.6 62.0 27.4 ref ref  Yes (twins or more) 1056 7.5 65.4 27.1 0.5 0.3 to 0.9 1.0 0.7 to 1.2 Mother’s educational level  Lower (ISCED levels 0–2: lower secondary or lower) 589 13.7 58.9 27.4 2.0 1.1 to 3.5 0.9 0.7 to 1.3  Intermediate (ISCED levels 3–5: upper or post-secondary, non-tertiary or short cycle tertiary) 1474 9.7 64.0 26.3 1.4 0.9 to 2.2 0.8 0.7 to 1.1  Higher (ISCED levels 6–8: bachelor degree or higher) 1478 6.3 66.3 27.4 Ref Ref Country of birth  Native 2857 8.9 63.5 27.6 Ref Ref  European born 238 7.7 63.9 28.4 0.9 0.4 to 2.0 0.8 0.5 to 1.2  Born outside Europe 476 13.3 61.9 24.9 2.5 1.4 to 4.2 1.4 1.0 to 1.9 GA, completed weeks  <26 305 5.5 53.9 40.6 0.2 0.1 to 0.4 0.3 0.2 to 0.5  26–27 657 6.0 54.2 39.9 0.2 0.1 to 0.4 0.5 0.4 to 0.6  28–29 937 6.3 66.1 27.6 0.3 0.2 to 0.5 0.7 0.6 to 0.9  30–31 1688 13.8 66.2 20.0 Ref Ref Small for GA**  <3 centile 766 7.7 62.0 30.2 0.5 0.3 to 0.7 0.7 0.5 to 0.9  3–9 centile 417 11.0 59.3 29.6 1.0 0.6 to 1.6 0.7 0.5 to 0.9  >10 centile 2404 10.2 63.8 26.0 Ref Ref Severe neonatal morbidity††  No 3141 10.4 63.5 26.1 Ref Ref  Yes 365 5.0 57.7 37.3 0.5 0.2 to 1.1 0.9 0.7 to 1.3 Bronchopulmonary dysplasia  No 3034 10.7 64.4 24.9 Ref Ref  Yes 466 3.8 53.8 42.4 0.4 0.2 to 0.8 0.6 0.5 to 0.9 Congenital anomaly  No 3292 9.9 62.7 27.4 Ref Ref  Yes 295 8.5 65.5 26.0 0.6 0.3 to 1.2 0.9 0.6 to 1.2 Child sex  Male 1914 10.0 59.3 30.7 0.9 0.6 to 1.3 0.7 0.6 to 0.9  Female 1673 9.4 67.1 23.5 Ref Ref Country (region) (ref sample mean) (ref sample mean)  Portugal (Lisbon, Northern Region) 425 4.8 36.8 58.4 0.6 0.3 to 1.2 0.2 0.1 to 0.2  Belgium (Flanders) 259 12.8 40.5 46.7 3.6 2.0 to 6.3 0.3 0.2 to 0.4  Netherlands (Central Eastern) 146 6.3 52.2 41.5 1.7 0.7 to 4.1 0.5 0.3 to 0.7  France (Burgundy, Ile-de-France, Northern Region) 770 10.3 58.6 31.2 3.0 1.9 to 4.6 0.6 0.5 to 0.8  Denmark (Eastern Region) 151 10.8 62.5 26.7 6.3 2.9 to 13.8 0.9 0.6 to 1.4  Sweden (Greater Stockholm) 141 2.8 70.7 26.6 1.1 0.2 to 6.3 1.0 0.7 to 1.5  UK (East Midlands, Northern, Yorkshire and the Humber) 419 13.6 69.4 17.0 10.9 6.1 to 19.4 1.9 1.4 to 2.7  Germany (Hesse, Saarland) 266 21.5 65.4 13.0 21.1 11.3 to 39.4 1.9 1.2 to 3.1  Estonia (entire country) 133 0.0 87.2 12.8 0.0 0.0 to 0.0 2.6 1.6 to 4.2  Italy (Emilia-Romagna, Lazio, Marche) 691 4.5 83.2 12.3 4.5 2.3 to 8.7 2.5 1.9 to 3.3  Poland (Wielkopolska) 186 13.4 75.7 10.9 18.9 9.4 to 38.3 2.9 1.8 to 4.8 Inverse probability weights after multiple imputation were used for all analyses. *Using intrauterine charts modelled for the Effective Perinatal Intensive care in Europe cohort. †Intraventricular haemorrhage grades III and IV, cystic periventricular leucomalacia, retinopathy of prematurity stages III–V or necrotising enterocolitis needing surgery. aRRR, adjusted relative risk ratio; GA, gestational age; ISCED, International Standard Classification of Education. France: French National Institute of Public Health Research (IRESP TGIR 2009–01 programme)/Institute of Public Health and its partners (the French Health Ministry, the National Institute for Health and Medical Research), the National Institute of Cancer and the National Solidarity Fund for Autonomy), the National Research Agency through the French EQUIPEX programme of investments for the future (grant

• Publisher: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Aftercare - statistics & numerical data / Child Development / Child Welfare - statistics & numerical data / Child, Preschool / Epidemiology / Ethics / Europe / Families & family life / Follow-Up Studies / Funding / Gestational age / Health problems / health services research / Humans / Infant / Infant, Extremely Premature / Infant, Newborn / Intensive care / International standards / Life Sciences / Lung diseases / Medical research / Multiple births / neonatology / Newborn babies / Patient Discharge - statistics & numerical data / PostScript / Premature Birth / Prevalence / Public health / Risk Factors / Sociodemographics