Abstract
This study presents a summary of the results from two cohorts of children born very preterm, EPIPAGE-2 (Epidemiological Study of Small Gestational Ages) in France, and EPICE-SHIPS (« Effective Perinatal Intensive Care in Europe ») in Europe. In 2011, these two cohorts collected data on very preterm infants and their families between birth and age 10. The survival of very preterm infants has improved over the past 25 years, but with significant differences between countries, particularly for extreme prematurity. At preschool age in France, 28% of children born at 24-26 weeks, 19% of those born at 27-31 weeks, and 12% of children born at 32-34 weeks had moderate to severe impairments, compared with 5% of children born at term. 52% of children born at 24-26 weeks of gestation received specialized care, compared to 33% at 27-31 weeks, 26% at 32-34 weeks, and 25% at term. Among children with moderate to severe disabilities, 30-40% did not receive any specialized care. In Europe, the percentage of children receiving such care varied from 28% to 50% depending on the European region. These cohorts provided original data on the prognosis of children born very preterm, its evolution over time, and the care offered. They helped to redefine certain practices, healthcare organization methods and public health policies. Despite the progress made, these children, who represent only 1% of births, account for 50% of perinatal deaths and 50% of disabilities associated with the perinatal period. Nearly 15 years after EPIPAGE-2 and EPICE, the question arises of re-evaluating the care and prognosis for these children.