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. 2003 Sep;88(5):F415–F420. doi: 10.1136/fn.88.5.F415

Use of healthcare resources, family function, and socioeconomic support during the first four years after preterm birth

I Leijon, O Finnstrom, G Sydsjo, M Wadsby
PMCID: PMC1721610  PMID: 12937048

Abstract

Objectives: To assess the use of healthcare resources for preterm infants and to evaluate family function and socioeconomic support in a defined population from birth to 4 years of age.

Methods: In a prospective case-control study, 39 singleton preterm infants without prenatal abnormalities born during an 18 month period were studied together with their families. The population consisted of 19 very preterm infants (less than 32 weeks) and 20 randomised moderate preterm infants (32–35 weeks), and the control group comprised 39 full term infants. Contacts with medical services, child health services, and the social welfare system were registered, and family function and life events were studied.

Results: The preterm children were more often readmitted to hospital (odds ratio (OR) 6.6, 95% confidence interval (CI) 2.0 to 22.1) and had more outpatient attendances (OR 5.6, 95% CI 2.1 to 15.0) during their first year of life. Mothers in the preterm group more often used temporary parental allowance than the control mothers (p < 0.001). The number of contacts with the child health services and the social welfare system did not differ significantly from the controls. Neither was there any significant difference with regard to family function or life events at 4 years of age.

Conclusions: A large proportion of the premature children used specialist care during the first years of life. However, the families of the preterm infants were socially well adapted up to four years after birth compared with the control families.

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Figure 1.

Figure 1

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A form based on Coddington's16 original questionnaire and Hurme's revised version for Scandinavia designed to obtain information on life events.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bylund B., Cervin T., Finnström O., Gäddlin P. O., Kernell A., Leijon I., Sandstedt P., Wärngård O. Morbidity and neurological function of very low birthweight infants from the newborn period to 4 y of age. A prospective study from the south-east region of Sweden. Acta Paediatr. 1998 Jul;87(7):758–763. doi: 10.1080/080352598750013842. [DOI] [PubMed] [Google Scholar]
  2. Coddington R. D. The significance of life events as etiologic factors in the diseases of children. II. A study of a normal population. J Psychosom Res. 1972 Jun;16(3):205–213. doi: 10.1016/0022-3999(72)90045-1. [DOI] [PubMed] [Google Scholar]
  3. Finnström O., Otterblad Olausson P., Sedin G., Serenius F., Svenningsen N., Thiringer K., Tunell R., Wesström G. Neurosensory outcome and growth at three years in extremely low birthweight infants: follow-up results from the Swedish national prospective study. Acta Paediatr. 1998 Oct;87(10):1055–1060. doi: 10.1080/080352598750031374. [DOI] [PubMed] [Google Scholar]
  4. Grögaard J. B., Lindstrom D. P., Parker R. A., Culley B., Stahlman M. T. Increased survival rate in very low birth weight infants (1500 grams or less): no association with increased incidence of handicaps. J Pediatr. 1990 Jul;117(1 Pt 1):139–146. doi: 10.1016/s0022-3476(05)72462-8. [DOI] [PubMed] [Google Scholar]
  5. Hack M., Weissman B., Breslau N., Klein N., Borawski-Clark E., Fanaroff A. A. Health of very low birth weight children during their first eight years. J Pediatr. 1993 Jun;122(6):887–892. doi: 10.1016/s0022-3476(09)90012-9. [DOI] [PubMed] [Google Scholar]
  6. Hägglöf B., Blom L., Dahlquist G., Lönnberg G., Sahlin B. The Swedish childhood diabetes study: indications of severe psychological stress as a risk factor for type 1 (insulin-dependent) diabetes mellitus in childhood. Diabetologia. 1991 Aug;34(8):579–583. doi: 10.1007/BF00400277. [DOI] [PubMed] [Google Scholar]
  7. Hök B., Hägglöf B., Thernlund G. Life events and behavioural deviances in childhood: a longitudinal study of a normal population. Eur Child Adolesc Psychiatry. 1995 Jul;4(3):153–164. doi: 10.1007/BF01980454. [DOI] [PubMed] [Google Scholar]
  8. Jackson K., Schollin J., Bodin L., Ternestedt B. M. Utilization of healthcare by very-low-birthweight infants during their first year of life. Acta Paediatr. 2001 Feb;90(2):213–217. doi: 10.1080/080352501300049488. [DOI] [PubMed] [Google Scholar]
  9. Köhler L. Health control of four-year-old children. An epidemiological study of child health. Acta Paediatr Scand Suppl. 1973;235:1–28. [PubMed] [Google Scholar]
  10. McGuire J., Richman N. The prevalence of behavioural problems in three types of preschool group. J Child Psychol Psychiatry. 1986 Jul;27(4):455–472. doi: 10.1111/j.1469-7610.1986.tb00634.x. [DOI] [PubMed] [Google Scholar]
  11. Olson D. H. Circumplex Model VII: validation studies and FACES III. Fam Process. 1986 Sep;25(3):337–351. doi: 10.1111/j.1545-5300.1986.00337.x. [DOI] [PubMed] [Google Scholar]
  12. Scheffzek A., Stahl M., von Toenges V. Die Prognose der sehr kleinen Frühgeburt. Katamnestische Untersuchungen an Frühgeborenen bis zu einem Geburtsgewicht von 1000 Gramm. Monatsschr Kinderheilkd. 1989 Jan;137(1):42–48. [PubMed] [Google Scholar]
  13. Schothorst P. F., van Engeland H. Long-term behavioral sequelae of prematurity. J Am Acad Child Adolesc Psychiatry. 1996 Feb;35(2):175–183. doi: 10.1097/00004583-199602000-00011. [DOI] [PubMed] [Google Scholar]
  14. Sommerfelt K., Troland K., Ellertsen B., Markestad T. Behavioral problems in low-birthweight preschoolers. Dev Med Child Neurol. 1996 Oct;38(10):927–940. doi: 10.1111/j.1469-8749.1996.tb15049.x. [DOI] [PubMed] [Google Scholar]
  15. Stjernqvist K. M. Extremely low birth weight infants less than 901 g. Impact on the family during the first year. Scand J Soc Med. 1992 Dec;20(4):226–233. doi: 10.1177/140349489202000407. [DOI] [PubMed] [Google Scholar]
  16. Stjernqvist K., Svenningsen N. W. Ten-year follow-up of children born before 29 gestational weeks: health, cognitive development, behaviour and school achievement. Acta Paediatr. 1999 May;88(5):557–562. doi: 10.1080/08035259950169594. [DOI] [PubMed] [Google Scholar]
  17. Sydsjö G. Prevalence and significance of social and psychological risk factors during pregnancy. Int J Technol Assess Health Care. 1992;8 (Suppl 1):123–128. doi: 10.1017/s0266462300013015. [DOI] [PubMed] [Google Scholar]
  18. Wadsby M., Sydsjö G., Svedin C. G. Children of psychosocial risk-mothers: life events, social interaction, and behaviour problems at the age of 8 years. Scand J Soc Med. 1996 Dec;24(4):227–236. doi: 10.1177/140349489602400402. [DOI] [PubMed] [Google Scholar]
  19. Yüksel B., Greenough A. Birth weight and hospital readmission of infants born prematurely. Arch Pediatr Adolesc Med. 1994 Apr;148(4):384–388. doi: 10.1001/archpedi.1994.02170040050008. [DOI] [PubMed] [Google Scholar]
  20. van Zeben-van der Aa D. M., Verloove-Vanhorick S. P., Brand R., Ruys J. H. The use of health services in the first 2 years of life in a nationwide cohort of very preterm and/or very low birthweight infants in The Netherlands: rehospitalisation and out-patient care. Paediatr Perinat Epidemiol. 1991 Jan;5(1):11–26. doi: 10.1111/j.1365-3016.1991.tb00680.x. [DOI] [PubMed] [Google Scholar]

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