About 1 in 2 babies born severely preterm are at risk of developing even a mild neurodevelopmental disorder. That is, they are at risk of cognitive and emotional problems, such as learning disabilities, deficits in executive function and attention, hyperactivity and emotional problems in school age. This was highlighted by Sinpia, the Italian Society of Child and Adolescent Neuropsychiatry, on the occasion of World Prematurity Day of 17 November. Sinpia points out that every year 15 million children in the world (more than one in every 10 born) are born premature, i.e. before 37 weeks of gestational age.
The incidence is increasing in almost all countries: in Italy every year more than 30,000 premature babies are born, equal to 7% of births. The difficulties that can arise with preterm birth are not limited to the first years of the child’s life, but can also arise later, in school age for example, especially in extremely preterm births. According to the Scientific Society, in seriously premature children of school age, for example, Qi scores, even if within normal limits, can be on average about 11-15 standard points lower than those born at full term of the same age. Early interventions and follow-ups, i.e. checks scheduled over time, are essential to reduce the risk.
To be truly effective, follow-up should last at least 6 years and, alongside the classic medical, nutritional, respiratory components, provide for a significant part related to neurodevelopment.
“Child neuropsychiatrists, in collaboration with neonatologists and paediatricians – concludes Antonella Costantino, Past President Sinpia – follow the development of preterm children in the neonatal follow-up services, ensuring periodic checks for the identification of early signs of atypical development. They also have an essential role in providing parents with indications on the management of the preterm child, on the strategies for promoting his neuropsychic development and for reducing the stress resulting from the preterm birth and for activating and coordinating early enabling interventions in situations at risk or in which a neurodevelopmental disorder is already present”.
The care and support for the family of the preterm infant cannot end at the time of discharge from the hospital, but they must necessarily continue over time, at least up to 6 years of life. This is what the Italian Society of Neonatology (SIN) advises in new scientific and operational manual on the care of children born before the 32nd week of pregnancy. The volume is entitled “The follow-up of the preterm infant. The first six years of life”.
Preterm infants may have developmental and neuropsychiatric problems, with consequences that in some cases may continue to grow. These can be reduced or avoided by early identification of developmental abnormalities and early individualized interventions. Mainly due to the lack of human and professional resources, however, there are still few services that are able to carry out the continuation of care after discharge from the Neonatal Intensive Care Unit (NICU) until the child enters school.
The manual, the result of collaboration with professionals from the Italian Society of Child Neuropsychiatry and the Istituto Superiore di Sanità and the Association of Parents Vivere Onlus, aims to improve follow-up services, standardize evaluation and intervention methods, providing shared tools for developmental assessment of preterm infants, based on the latest evidence. The volume will be presented on November 9, at the Mangiagalli Clinic in Milan in a meeting in view of the World Prematurity Day, which is celebrated on November 17.