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New NICE guideline on Developmental follow-up of children and young people born preterm

We are pleased to announce the publication of the following NICE guideline developed by the National Guideline Alliance (NGA)

Preterm birth, defined as birth before 37 weeks’ gestation, can be associated with short and long-term medical problems. While most babies born preterm will have good medical and developmental outcomes, some will have enduring problems. In 2014, 48,985 babies were born preterm in the UK (7.4% of all live births). Of these, 2,438 (0.4% of all live births) were born 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 rises sharply in children born before 28 weeks' gestation. Most major disorders are detectable in the first two years of life but some developmental disorders and problems, particularly those that have an impact on the child's educational participation and attainment, may not be apparent until they are four years or older.

Identifying developmental problems and disorders in all children (born preterm or at term) in England is currently done through the Healthy Child Programme up until the age of five years.

This guideline aims to improve the identification of developmental problems and disorders in children born preterm by recommending that enhanced surveillance and support programme is established for those with problems or disorders, or who are at high risk of developing them. It is recommended an enhanced programme should include two face-to-face follow-up visits in the first year that focus on development and a detailed face-to-face developmental assessment at two years. The guidance also recommends that an additional developmental assessment takes place at age four years for children born at less than 28 weeks’ gestation to identify problems that become more apparent at school age, with a view to supporting education plans. The guideline makes recommendations concerning who should carry out these assessments, and what they should include, including the use of parent-completed screening questionnaires and IQ tests.

In addition to the surveillance programme, this guideline also recommends the support to be offered to parents and carers of all children and young people born preterm, including advice on what support should be provided if developmental problems or disorders are identified later in childhood or through the education services.

"Developmental follow-up of children and young people born preterm" [NG72] is now published on the NICE website.

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