Developmental follow-up of children and young people born preterm

Context

This guideline focuses on the specialist developmental support and surveillance needed for the early identification of developmental problems and disorders in children born preterm.

The proportion of babies born preterm in the UK, defined as birth before 37 weeks' gestation, has remained steady for several years at 7.4%. In 2014 this amounted to 48,985 from a total of 656,957 live births, of which 2438 (5% of preterm births and 0.4% of all births) were before 28 weeks' gestation.

Preterm birth is associated with an increased risk of developmental problems and disorders. These include developmental challenges, physical, sensory, cognitive and learning disorders, and emotional and behavioural problems. These may extend into adolescence and, in some cases, be lifelong. In particular, the risk and prevalence of impairments that affect educational attainment rise sharply in children born before 28 weeks' gestation. Although most major disorders are detectable in the first 2 years of life, several developmental disorders and problems, particularly those that have an impact on the child's ability to participate and on their educational attainment, may not be apparent until they are older.

This guideline aims to improve the identification of developmental problems and disorders in children born preterm by setting standards for follow-up. This is expected to improve outcomes for these children by reducing variation in follow-up and enabling benchmarking of neonatal care. Developmental surveillance up to and at 2 years (corrected age) is recommended for identifying major problems and disorders. A later developmental assessment for children at high risk aims to identify problems that are more apparent at school age, with a view to supporting education plans for the child.