Falling through the cracks: what happens to survivors of preterm birth?
Long-term consequences of preterm birth on health and life expectancy
Preterm birth has consequences across the course of life, including reduced life-expectancy, and the most prematurely born have the worst outcomes.
Survivors of prematurity have increased respiratory morbidity and mortality, airflow obstruction, asthma-like symptoms and COPD, and cardiovascular disease.
A history of prematurity is often not sought in adult clinics. We hypothesised that the long-term consequences of prematurity are insufficiently appreciated, likely with detriment to patient care.
The need for lifelong follow-up in preterm-born individuals
Most (>75%) of all those surveyed, believed that premature babies should be followed up lifelong.
Improving communication through lifelong electronic patient records
Going forward, the use of a lifelong electronic patient record, accessible to all who are involved in patient care, would likely greatly facilitate communication between specialist groups.
Lack of awareness and the need for international guidelines on preterm follow-up
In summary, there is inadequate awareness of the importance of preterm birth for management across the life course; communication between specialist teams is inadequate; and there is lack of clear guidance as to how to follow-up preterm born survivors.
An international consensus on how to structure respiratory follow-up remains an unmet need.
Strategies to improve long-term care for preterm-born individuals
Proposed mitigation strategies to improve the current situation include better continuing medical education. Another is empowering patients and caregivers by supplying accurate information which they can ensure is available to subsequent caregivers, including during transition to adult services.
Conclusion
In conclusion, we need to increase awareness of the long-term implications of prematurity to ensure optimal follow-up for these babies, and design studies to obtain an evidence base for the development of improved guidelines.
Authors
Andrew Bush, Anne Greenough, Alvar Agustí, Federico Bianco, Eugenio Baraldi
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Fecha de publicación
Published online 10 February 2025
Categorías asociadas al artículo
- AFO, Asma-Asthma, Bronchial infection-Infección bronquial, Childhood/Adulthood-Infancia/Edad adulta, Comorbidity-Comorbilidad, COPD-EPOC, CVDs-ECV, Encuesta - Survey, Ensayos-Trials, Estudios-Studies, Exacerbations-Exacerbaciones, Fibrosis, Investigación, Limitación del Flujo de Aire-Airflow Limitation, Lung function-Función pulmonar, Spirometry-Espirometría, Young COPD-EPOC young
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