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High Risks Of Learning Difficulties For Premature Babies

Posted Mar 13 2009 3:57pm

Doctors now have the capability to deliver babies that are only at 20 weeks - half the full term of a standard pregnancy. However, an ethical question mark overhangs the consequences of such a premature birth, with high numbers of babies developing a wide range of problems later on, including an inability to walk along with learning difficulties at school.

A team of experts conducted a study called EPICure - the largest long term investigation into the effects of being born extremely premature. The study looked at a group of children who were born in 1995, and researchers discovered that by the time the children had reached 11 years of age, over two-thirds were suffering from academic or behavioural problems, with 13 per cent attending special schools.

In comparison, 24 per cent of all schoolchildren across the whole of England attend special education.

In the study, 219 children who were born prematurely were compared to the performances of 150 classmates who had been born at full term.

It can be an impossibly hard decision for parents and doctors to gauge when it is and is not appropriate to attempt to keep a very premature baby alive. There is a collective feeling that with the advances and improvements over the last ten years in neonatal care, the future is looking brighter for premature babies.

However, a further study - EPICure-2 - which looks at babies born in 2006 - is set to be published soon, but is not expected to show a marked improvement.

The is an ongoing controversial difference of opinions about these issues. For example in the Netherlands, babies born under 25 weeks are refused intensive care in line with a national policy, which at the moment is under review. The UK does not operate such a policy, as it is strongly felt that parents must be involved in the decision making process, however there is a variation within each unit as to how they will proceed.

It can often be the case that premature babies show no clear signs of anything being wrong when born, causing parents huge relief. However, it can take some time for certain issues - especially those surrounding learning - to manifest, and yet they can have just as negative effect in the long term.

In the original reviews taken by the EPICure study, the children were studied at the ages of two-and-a-half and six. It was found that nearly half (46 per cent) suffered from moderate to severe disability due to cerebral palsy, low IQ, or blindness and deafness - this is compared to just 1 per cent of children who were born at full term.

Neil Marlow, professor of neonatal medicine at Nottingham University who led the study, published in Archives of Disease in Childhood, said, “The big challenge is to understand why things go so wrong… Is it care related or is it biologically determined?”

In 1995, there was a total of 1,289 babies born in the UK and Ireland at under 26 weeks gestation - 75 per cent of these babies did not survive much longer than a few days. The ones that did survive were the result of medical teams working tirelessly.

Professor Marlow stated that the problems children can face are significantly higher when they get to secondary school age and have to cope with more demanding school work. A possible option for some parents is to decide to delay their child’s entry.

“Evidence from Germany, the Netherlands, Canada and the US shows that when children are held back a year they need less support. That can make things easier for the child and de-stress the educational environment,” he said.

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