Follow-up protocol for newborns of birthweight less than 1500 g or less than 32 weeks gestation

Spanish survey on follow‐up programmes for children born very preterm

“…The results of a national survey analysing the characteristics of follow‐up programmes for VPT/VLBW children in Spain conducted during 2015 showed great heterogeneity in programme content, both between and within different neonatal levels of care. Remarkably, none of the follow‐up programmes fulfilled the recommendations regarding routine assessment by a paediatric specialist (such as an ophthalmologist or neurologist), included in the recently developed guidance document of the Spanish Neonatal Society . For clinicians running follow‐up programmes, the main perceived need was related to training.…”

“…The present study shows how the practices carried out in follow‐up clinics and their organisation are markedly heterogeneous and that for this reason, VPT/VLBW children in Spain are not receiving equitable care, despite the universality of the Spanish public health system. We expect that dissemination of the national protocol , enhancement of regionalisation, generalisation of the presence of a psychologist on follow‐up teams, and improvement in the training of professionals, will together not only standardise practice but will significantly increase the quality of survival and neurodevelopment of preterm infants. Therefore, we plan to conduct a new survey in the near future to determine whether implementation of the suggested areas for improvement has resulted in improved conditions in the care of VPT/VLBW children in Spain.…”

“…When the survey was conducted, guidance on standardised follow‐up care was unavailable and no minimum requirements had been established. The survey incorporated a series of specific questions about clinical assessments that were recommended in a recently issued Spanish national protocol . The degree of compliance with the recommended assessments was very low; in fact, no single centre met all recommendations.…”

“…Most questions referred to routine follow‐up visits, such as clinical visits performed for all children regardless of their health status. A set of questions aimed at obtaining baseline practice data on clinical assessments included in the recommendations were developed by the same panel that designed the survey, prior to the publication and dissemination of the guidance document. At the end of the questionnaire, respondents were asked to select and rank, from an 8‐item list, the main perceived needs related with setting‐up and running a follow‐up programme for VPT/VLBW children.…”

“…Until recently, Spain lacked specific national follow‐up guidelines for clinical practice. However, in 2017 the Spanish Neonatal Society, together with the Spanish Association of Primary Health Care Paediatrics, issued a detailed guidance document on the follow‐up of VPT/VLBW children . As part of the guidance development process, we launched a national survey to retrieve updated information regarding the characteristics of follow‐up programmes for VPT/VLBW in level II and level III NICUs in Spain.…”