Wide-ranging problems in children born before 24 weeks gestation

The findings are now published in the scientific journal Acta Paediatrica. The study was based on data in national registers and hospital journals on almost every child born in Sweden in 2007-2018, before the 24th week of gestation, who survived after birth up to what would have been full term (40 weeks).

Altogether, the study comprises 399 children. At follow-up, they were aged 2 to 13 years.

More than half need habilitation

Among these children born before 24 weeks of pregnancy,

• 75 percent had neuropsychiatric impairments, such as some degree of development disorder (40 percent); Attention-Deficit/Hyperactivity Disorder, ADHD (30 percent); and Autism (24 percent).
• 55 percent required habilitation support.
• 88 percent had other medical diagnoses, such as Asthma (63 percent) or postnatal growth restriction (39 percent).
• 17 percent had Cerebral Paresis.

Major support needs

The study shows the marked need for special support for the most immature children, born extremely preterm, and highlights the need for long-term habilitation.

"This is about the tiniest babies born, who wouldn't have survived without modern neonatal care," says Professor Ann Hellström of Sahlgrenska Academy, University of Gothenburg, the last author of the publication.

"Being born extremely preterm has long-term repercussions. Awareness needs to increase for society at large to provide sufficient resources during adolescence and later in life, manage morbidity, structure follow-up programs, and support for disabilities."

More survivors

Over the past 20 years, the survival rate among extremely premature babies has risen sharply, especially in those born in gestational weeks 22 and 23 . Thus, health care today can save the lives of children born more than four months too early. Enhanced survival has resulted in more knowledge of brain development among these children, and how their cognition, motor skills, hearing, and vision are affected.

This study is the first to provide a comprehensive picture of the prevalence of various diagnoses in the most immature of extremely preterm infants, and the expected substantial impact on the children's lives, in a single nationwide set of research data.

"Doctors and other health professionals need to be aware of the many health and developmental problems that affect these children. Health care services also need resources to identify their long-term treatment and support needs at an early stage," Hellström points out.

The study was conducted in a national collaboration among researchers focusing on newborns (neonatology) and medical conditions relating to the eye (ophthalmology). The corresponding author is Professor Ann Hellström of Sahlgrenska Academy, University of Gothenburg, while the first author is neonatologist Eva Morsing of Lund University.