Neurodevelopmental outcomes in early childhood for infants born very preterm in countries outside the UK

Knowledge of outcomes beyond the primary hospitalisation for infants born very preterm is vital to understanding the impact of interventions in the perinatal and newborn periods, particularly as more infants born <24 weeks’ gestation are being offered active care. van Blankenstein et al 1 report the outcomes at 2 years of age of children born <30 weeks in England and Wales between 2008 and 2018. In their study, 0.4% were blind, 1% had a substantial hearing impairment, and delays in language (13%) development (9%) and motor performance (8%) were frequent, based on responses from parent-completed questionnaires. The study raises the question of how their long-term outcome data compare with what is known for recent whole populations of births <30 weeks’ gestation outside of England and Wales.

Many countries outside the UK collect data on developmental outcomes into early childhood (2–3 years of age) that might be compared with the study of van Blankenstein et al. The gestational age or birth weight selection criteria vary between countries, as do the years of reporting of the data and the sample sizes of the cohorts (table 1). The attempted coverage of all survivors of the defined gestational age or birth weight within the region is 100% or close to it for some cohorts, whereas other databases encompass only approximately two-thirds or fewer of births within the geographical region. Of the eligible survivors, the follow-up rates into early childhood vary from 47% to 93%. Most, but not all, have used corrected age when the children have been assessed. The follow-up assessments predominantly involve direct assessments of neurosensory outcomes and of psychological development by health professionals. Other studies have relied on questionnaires completed …

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