Premature babies not having ‘essential’ checks at ages two and four – study

There is “worrying evidence” that children who are born prematurely are not consistently getting recommended developmental checks when they are toddlers and before they start school, a report has warned.

It is also “clear” that a target to reduce the rate of premature births to 6% by 2025 will not be met.

A preterm birth happens before the 37th week of pregnancy, with babies usually needing help to breathe, keep warm and fight infection in the first days or weeks of life.

According to the Lords’ Preterm Birth Committee, children who are born prematurely also have a higher risk of life-long conditions, as well as a higher likelihood of communication problems, autism and special needs.

We saw no evidence that action is being taken to address this failure, or to hold the relevant services accountable for delivery. Indeed, there even appears to be some uncertainty about where responsibility for these assessments lies

The National Institute for Health and Care Excellence (Nice) recommends that children born before 37 weeks should have developmental checks at age two.

During these assessments, healthcare workers should check for developmental problems or disorders, discuss concerns with parents, and take height, weight and head circumference measurements.

Children born before 28 weeks should also have a developmental assessment at age four, as some problems may only become apparent as the child grows.

The committee report said these follow-up checks are “essential” to determine if these children need extra support, and are an opportunity for “beneficial early intervention before children start school”.

However, it added: “There is worrying evidence that these are not consistently delivered at ages two and four, despite being recommended in Nice guidance.

“Provision of the assessment at age four appears to be especially low.

“We saw no evidence that action is being taken to address this failure, or to hold the relevant services accountable for delivery. Indeed, there even appears to be some uncertainty about where responsibility for these assessments lies.”

The committee called for “swift action” from the Government and NHS England to determine why these checks “are not being consistently delivered”.

According to the NHS, about eight in 10 babies will be born prematurely, while pregnancy and baby charity Tommy’s estimates there are about 53,000 preterm births in the UK every year.

In 2017, the government vowed to reduce the rate of premature births from 8% to 6% by 2025.

However, the report said “it is clear” the target will not be met.

Lord Patel, chair of the Preterm Birth Committee, said: “We heard stark evidence on the impact of preterm birth, which can be sudden and unexpected.

“While many babies born prematurely go on to do well, for some children and families, preterm birth has significant, and often lifelong, adverse consequences.

“Reducing the immediate and longer-term impacts of preterm birth should therefore remain a key objective.

“Improving outcomes for preterm babies and their families could also generate substantial cost savings within healthcare and education.”

The committee said a focus on “optimising” women’s health before pregnancy and tackling social deprivation and risk factors like smoking, obesity, drug use and mental health problems, will be “necessary” to achieve the 6% target.

It welcomed the “emphasis” the Labour Government has placed on sickness prevention and women’s health, and called for all women to have access to information and advice on pregnancy planning.

Lord Patel added: “Improving the life chances of the few requires effort by the many. We hope that the key findings of our report will form part of the co-ordinated effort needed to ensure that this happens.”

An NHS spokesperson said: “The NHS is committed to ensuring all women and babies receive high-quality care before, during and after their pregnancy, and while the health service has made improvements to maternity services in England over the last decade, we know further action is needed.

“We are increasing the number of midwives and obstetricians and our three-year delivery plan for maternity and neonatal services includes the Saving babies’ lives care bundle, which is supporting midwives and doctors to reduce the number of babies born early and provide the best care when preterm birth cannot be prevented.

“Local services and ICBs should commission developmental assessment checks in line with National Institute for Health and Care Excellence guidance to improve outcomes for babies born prematurely.”