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Background: Early childhood education offers opportunities for stimulation in multiple developmental domains and its positive impact on long-term outcomes and wellbeing for children is well documented. Few studies have explored early education in children born very preterm (VPT; <32 weeks of gestation) who are at higher risk of neurodevelopmental disorders and poor educational outcomes than their term-born peers. The purpose of the study is to describe and compare the educational environment of children born VPT in European countries at 5 years of age according to the degree of perinatal risk., Methods: Data originated from the population-based Screening to Improve Health In very Preterm infants (SHIPS) cohort of children born VPT in 2011/2012 in 19 regions from 11 European countries. Perinatal data were collected from medical records and the 5-year follow-up was conducted using parental questionnaires. Outcomes at 5 years were participation in early education (any, type, intensity of participation) and receipt of special educational support, which were harmonized across countries., Results: Out of 6,759 eligible children, 3,687 (54.6%) were followed up at 5 years (mean gestational age 29.3 weeks). At 5 years, almost all children (98.6%) were in an educational program, but type (preschool/primary), attendance (full-time/part-time) and use and type of school support/services differed by country. In some countries, children with high perinatal risk were more likely to be in full-time education than those with low risk (e.g. Estonia: 97.9% vs. 87.1%), while the inverse pattern was observed elsewhere (e.g. Poland: 78.5% vs. 92.8%). Overall, 22.8% of children received special educational support (country range: 12.4-34.4%) with more support received by children with higher perinatal risk. Large variations between countries remained after adjustment for socio-demographic characteristics., Conclusions: There are marked variations in approaches to early education for children born VPT in Europe, raising opportunities to explore its impact on their neurodevelopment and well-being., (© 2024. The Author(s).)

Background: Children born very preterm (<32 weeks of gestation) face high risks of neurodevelopmental and health difficulties compared with children born at term. Follow-up after discharge from the neonatal intensive care unit is essential to ensure early detection and intervention, but data on policy approaches are sparse., Methods: We investigated the characteristics of follow-up policy and programmes in 11 European countries from 2011 to 2022 using healthcare informant questionnaires and the published/grey literature. We further explored how one aspect of follow-up, its recommended duration, may be reflected in the percent of parents reporting that their children are receiving follow-up services at 5 years of age in these countries using data from an area-based cohort of very preterm births in 2011/12 (N = 3635)., Results: Between 2011/12 and 22, the number of countries with follow-up policies or programmes increased from 6 to 11. The policies and programmes were heterogeneous in eligibility criteria, duration and content. In countries that recommended longer follow-up, parent-reported follow-up rates at 5 years of age were higher, especially among the highest risk children, born <28 weeks' gestation or with birthweight <1000 g: between 42.1% and 70.1%, vs. <20% in most countries without recommendations., Conclusions: Large variations exist in follow-up policies and programmes for children born very preterm in Europe; differences in recommended duration translate into cross-country disparities in reported follow-up at 5 years of age., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association.)

Background: The Movement Assessment Battery for Children-Second Edition (Movement ABC-2) is widely used to assess children's motor function, yet there is a lack of normative data for many countries., Aims: To assess the extent to which the application of different population reference norms for the Movement ABC-2 affects the classification and prevalence of motor impairment., Design: Data were obtained from two Portuguese regions participating in the Screening to Improve Health in Very Preterm Infants in Europe (SHIPS) Study, which was a five year follow-up of a cohort of children born at <32 weeks' gestation in 2011-2012 in 19 regions in 11 European countries. Perinatal data were extracted from medical records and the Movement ABC-2 was administered at five years of age., Subjects: Of 542 Portuguese children eligible for the five-year follow-up, 413 (76.2%) were evaluated., Outcome Measures: Movement ABC-2 raw scores were converted to standardized scores using norms from four countries with national standardisations (UK, Netherlands/Belgium, France and Italy)., Results: The prevalence of significant movement difficulties (total score ≤ 5th percentile) was 28.5% using Dutch/Flemish norms, 23.3% using French norms, 16.5% using UK norms and 11.4% using Italian norms; 10.8% and 68.3% of the children were consistently classified as having significant movement difficulties and as not having significant movement difficulties, respectively, according to any norms. However, for 20.9% of children there was a disagreement in motor function status using different norms., Conclusion: The use of different test norms has a large impact on the proportion of children classified with significant movement difficulties, with implications for clinical referrals, healthcare costs and research. Our results underscore the importance of using appropriately validated tests with sound psychometric properties, and raise questions about the large differences in norms for the Movement ABC-2 in European countries., Competing Interests: Declaration of competing interest The authors have no potential conflicts of interest relevant to this article to disclose., (Copyright © 2020 Elsevier B.V. All rights reserved.)