Doctor: Anna-Veera Seppanen
Title: Impact of socioeconomic factors on follow-up and health service use up to 5 years of age in a European cohort of children born very preterm
Supervisor: Jennifer Zeitlin
Doctoral school: ED 393 Epidemiology and Biomedical Information Sciences, Université de Paris
Date of thesis defense: 12/2020
Jury: Pascal Astagneau
Children born very preterm, before 32 weeks’ gestation, are at risk of adverse long-term health and developmental consequences; a risk that may further be augmented by social factors. Follow-up of these children is essential for timely identification and management of emerging sequelae, but studies suggest that follow-up and health service use may be inequitable. We aimed to describe routine follow-up and health service use among children born very preterm in 19 regions in 11 European countries, and assess whether follow-up is associated with health care services use and care equity. We used data from the population-based Effective Perinatal Intensive Care in Europe (EPICE) cohort of very preterm births in 2011/2012. This thesis provides novel data revealing high rates of health care service use at two and five years of age, as well as large variation in service use and follow-up across European countries. The results also suggest that children from socially vulnerable families receive less optimal health care and follow-up. We also found that parents of children with health or developmental problems were less satisfied with the care received by their children. Our results constitute a basis for future research and benchmarking health service provision and raise further questions about the optimal organisation and availability of care and follow-up.