New guidelines to improve long-term care of preterm babies

About 3500 babies are born very preterm in Australia every year. Of which about 60% will experience difficulties.

New clinical practice guidelines have been released with an aim to improve care of preterm babies — those born before 32 weeks’ gestation — from the time they leave hospital up until six years of age.

Led by Murdoch Children’s Research Institute (MCRI)’s Centre of Research Excellence in Newborn Medicine, the guidelines have been developed alongside a team of neonatologists, paediatricians, clinicians, maternal and child health nurses, and those with lived experiences of preterm birth from across Australia.

MCRI’s Dr Jamie Owen said, “These Australian first guidelines detail how GP clinics, hospitals and other healthcare centres can work together to ensure all children have access to transformative, ongoing care and any health concerns are identified and treated early.”

To avoid these gaps in care, every family with a child born very preterm should be guided by a co-ordinated, multidisciplinary team, Owen said.

The guidelines recommended structured and specific post-discharge care for very preterm babies who were at an increased risk of growth, health and developmental problems, MCRI Professor Jeanie Cheong said.

“Children born very preterm require intensive medical care to survive,” Cheong said.

Treatment for these children has advanced over time and survival rates have significantly improved. But due to their early birth they face potential health setbacks including delayed growth, elevated blood pressure, hearing loss, neurodevelopmental and sleep problems, language delay and autism.

“Some difficulties present early in life and others during the preschool years. Very preterm birth is distressing for caregivers and families and, along with the additional carer burden, can have consequences for family wellbeing, mental health and quality of life.”

Cheong said follow-up services for children born very preterm varied considerably across Australia. “A lack of consistency in follow-up care at hospitals and other medical and community services has led to many children missing out on important assessments for identifying health issues and access to timely referrals,” she said.

“It’s critically important that difficulties are identified early to ensure children receive appropriate, early intervention.

“Follow-up care, needs to be tailored to each child and initiated by each hospital’s Neonatal Intensive Care Unit (NICU) team. Post-discharge care may involve many healthcare professionals and services, making co-ordination between these teams essential to maximise efficiency, reduce duplication and lessen the burden on families,” Owen said.

The guidelines have been approved by the National Health and Medical Research Council (NHMRC) and will be reviewed in five years’ time and updated with any additional evidence-based recommendations, MCRI said in a statement.

Further funding, Cheung said, would also help extend follow-up care for those born preterm throughout their schooling years and into adulthood.

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