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

Premature babies across the UK are not receiving the necessary developmental checks at ages two and four, a report has revealed. The report highlights concerns that children born prematurely are missing out on crucial assessments before starting school. It also indicates that a target aimed at reducing the rate of premature births to 6% by 2025 is unlikely to be achieved.

A preterm birth occurs before the 37th week of pregnancy, requiring newborns to receive immediate assistance with breathing, staying warm, and battling infections in their early days or weeks of life. According to the Lords’ Preterm Birth Committee, children born prematurely face a higher risk of lifelong health issues, as well as an increased likelihood of communication difficulties, autism, and special needs.

The National Institute for Health and Care Excellence (Nice) suggests that children born before 37 weeks should undergo developmental checks at the age of two. These assessments involve healthcare professionals checking for developmental issues, discussing concerns with parents, and recording measurements such as height, weight, and head circumference. Additionally, children born before 28 weeks should have a developmental evaluation at age four to detect any problems that may arise as they grow.

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The committee’s report emphasised the importance of these follow-up checks in identifying children who may require additional support and enabling early intervention before they commence school. However, there are growing concerns that these assessments are not consistently carried out at ages two and four, despite being recommended in Nice guidelines. Of particular worry is the low provision of assessments at age four.

The committee stressed the need for urgent action from the Government and NHS England to investigate why these essential checks are not being consistently delivered. Around eight in 10 babies are born prematurely, with approximately 53,000 preterm births occurring in the UK annually, as estimated by pregnancy and baby charity Tommy’s.
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In 2017, the government set a target to reduce the rate of premature births from 8% to 6% by 2025. However, the report indicates that this target is unlikely to be met. Lord Patel, chair of the Preterm Birth Committee, highlighted the significant and often lifelong adverse consequences of preterm birth on some children and families. Therefore, mitigating the immediate and long-term impacts of preterm birth remains a critical objective.

The committee recommended a focus on enhancing women’s health before pregnancy, addressing social deprivation, and tackling risk factors such as smoking, obesity, substance use, and mental health issues to achieve the 6% target. It praised the Labour Government for prioritising sickness prevention and women’s health while advocating for universal access to pregnancy planning information and advice.

According to an NHS spokesperson, efforts are being made to ensure that all women and babies receive high-quality care throughout and after pregnancy. While improvements have been made in maternity services in England, further action is necessary. The NHS is increasing the number of midwives and obstetricians and implementing initiatives to support midwives and doctors in reducing the number of premature births and providing optimal care when preterm birth cannot be prevented.

The committee’s report underlines the need for collaborative efforts to enhance outcomes for preterm babies and their families, which could lead to significant cost savings in healthcare and education. It hopes that the key findings will contribute to a coordinated approach aimed at improving the life chances of preterm babies.