The Importance of Long-Term and Multi-Agency Follow-Up for Children Born Premature

Abstract

This brief communication introduces a new position paper, ‘Prematurity in Aotearoa New Zealand’, for professionals about the effects on our pēpē (babies) and tamariki (children) of having been born early. It was commissioned by the Champion Foundation in Ōtautahi Christchurch. The authors, Drs Patricia Champion and Alison Davie-Gray, provide a comprehensive summary of recent multi-disciplinary research in the field. The paper can be downloaded at no cost from the Champion Centre website—https://www.championcentre.org.nz/resources-for-professionals.html. Prematurity is an area of expertise for neonatal specialists, but the effects of prematurity are now well-established as having possible or probable lifelong impacts for those born early and their whānau (families). The Champion Centre, which runs a longstanding, follow-up and early intervention programme for babies and pre-schoolers born premature, recognises the need for accessible, evidence-based information for non-specialist professionals working with children beyond their pre-school years in health, education and social services. The report, which is clinically informed and based on an extensive review of the international literature, synthesises the silos of research evidence about prematurity as it relates to developmental science, which has not been previously provided in an international context.

Around 7% of children born in Aotearoa New Zealand are born premature. International evidence suggests that a preterm birth may result in vulnerabilities and differences for the developing brain, as well as other organs, which in turn may affect learning, health and wellbeing throughout childhood and beyond [1]. The research shows that children and adults who were born early are most likely to experience ongoing effects, especially (but not only) if they were born very early, with children being born under 32 weeks being most at risk (around 1%–2% of the population); and particularly if they are growing up with families who have additional social, health, mental health or economic challenges [2]. Research is clear that effects on the brain may not emerge until tamariki are at pre-school age or beyond, by which stage, children in New Zealand will not generally be followed up by specialist health-care providers.

Research highlights in particular the vulnerability of emerging self-regulation skills for children born premature. Self-regulation skills are now regarded as key building blocks for positive developmental outcomes. When children have difficulty acquiring these skills, it can have long-term effects on learning, attention, behaviour and emotional well-being. Parents can, however, make an important contribution to the self-regulatory skill capacity of their children. The report makes the case for the availability of early intervention with tamariki and their whānau, to understand and establish these foundational skills. Evidence suggests these skills must be underpinned by positive parent/child interactions. The evidence is clear that all children, whether preterm or full term, are likely to have more positive developmental outcomes when their primary caregiving relationships are sensitive, responsive and nurturing.

Prematurity has important implications around the world for policy, practice and funding of services in a range of contexts, including health care, education, social and justice sectors [3]. The paper focuses on New Zealand but includes a review of international best practice in services for premature children. The report has been endorsed by international experts in the field: among them, Professor Neil Marlow, Emeritus Professor of Neonatology, University College London, who said, ‘It is mandatory reading for all professionals and health care planners as it sets out the huge long-term benefits for families from well-targeted intervention and service provision for this neglected group’.

The authors completed the ICMJE disclosure of interest form (available upon request from the corresponding author).

The authors have nothing to report.

The authors declare no conflicts of interest.