Seppänen Anna-Veera, Barros Henrique, Draper Elizabeth S, Petrou Stavros, Andronis Lazaros, Kim Sungwook, Maier Rolf F, Pedersen Pernille, Gadzinowski Janusz, Pierrat Véronique, Sarrechia Iemke, Lebeer Jo, Ådén Ulrika, Toome Liis, Thiele Nicole, van Heijst Arno, Cuttini Marina, Zeitlin Jennifer
Université de Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Paediatric Epidemiology Research Team (EPOPé), Paris, France.
EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.
Eur J Public Health. 2024 Feb 5;34(1):91-100. doi: 10.1093/eurpub/ckad192.
Children born very preterm (<32 weeks of gestation) face high risks of neurodevelopmental and health difficulties compared with children born at term. Follow-up after discharge from the neonatal intensive care unit is essential to ensure early detection and intervention, but data on policy approaches are sparse.
We investigated the characteristics of follow-up policy and programmes in 11 European countries from 2011 to 2022 using healthcare informant questionnaires and the published/grey literature. We further explored how one aspect of follow-up, its recommended duration, may be reflected in the percent of parents reporting that their children are receiving follow-up services at 5 years of age in these countries using data from an area-based cohort of very preterm births in 2011/12 (N = 3635).
Between 2011/12 and 22, the number of countries with follow-up policies or programmes increased from 6 to 11. The policies and programmes were heterogeneous in eligibility criteria, duration and content. In countries that recommended longer follow-up, parent-reported follow-up rates at 5 years of age were higher, especially among the highest risk children, born <28 weeks' gestation or with birthweight <1000 g: between 42.1% and 70.1%, vs. <20% in most countries without recommendations.
Large variations exist in follow-up policies and programmes for children born very preterm in Europe; differences in recommended duration translate into cross-country disparities in reported follow-up at 5 years of age.
与足月儿相比，极早产儿（妊娠<32周）面临神经发育和健康问题的高风险。新生儿重症监护病房出院后的随访对于确保早期发现和干预至关重要，但关于政策方法的数据却很少。
我们使用医疗保健知情者问卷以及已发表/灰色文献，调查了2011年至2022年期间11个欧洲国家的随访政策和项目的特点。我们还利用2011/12年一个基于地区的极早产队列（N = 3635）的数据，进一步探讨了随访的一个方面，即其推荐时长，如何体现在这些国家中报告孩子在5岁时接受随访服务的父母比例上。
在2011/12年至2022年期间，有随访政策或项目的国家数量从6个增加到11个。这些政策和项目在资格标准、时长和内容方面存在差异。在推荐更长随访时长的国家，5岁时父母报告的随访率更高，尤其是在最高风险的儿童中，即妊娠<28周或出生体重<1000克的儿童：在42.1%至70.1%之间，而在大多数没有相关推荐的国家中这一比例<20%。
欧洲极早产儿的随访政策和项目存在很大差异；推荐时长的差异导致了各国在5岁时报告的随访情况上的差异。
