Review of methods for neurodevelopmental follow-up of preterm infants after two years of age
A review was undertaken of the role and rationale for neuro-developmental follow-up of preterm infants after two years of age. Data from a wide range of studies show marked differences in neurological and health status, intellectual functioning, school performance and behaviour between children born prematurely and those born at term. Assessment in later childhood can identify more subtle problems than the severe disability or sensory deficits that are readily identifiable at two years. The review, which utilised these studies, focused on the areas for assessment, the instruments in current use, choices in relation to the form and timing of follow-up and put forward guidelines in relation to these. Given developments in clinical practice and the changing case-mix of infants administered neonatal intensive acre, it will be necessary to continue to measure outcomes for children born preterm. Follow-up to school entry and beyond is required to determine the true prevalence and nature of the neuro-developmental problems arising from preterm birth; consensus about the assessment methods used, definitions of disability and health status and age at assessment is necessary and should allow more effective comparison across populations. Assessment of outcome for children born preterm beyond two years is needed in order to counsel parents, plan health and education provision, for evaluation of services and to facilitate understanding of the longer term effects of preterm birth on brain development.