MAPS - Multiple Long-term Conditions and Prematurity Study

MAPS – Multiple Long-term Conditions and Prematurity Study

Understanding the long-term health impact of preterm birth.

Survival following preterm birth is increasing, but many survivors live with long-term complications. We aimed to estimate the prevalence of multiple long-term conditions (MLTC) and healthcare usage among children in the early childhood, comparing those born preterm and at term.

Every year in the UK there are 60,000 preterm births (before 37 weeks of pregnancy), 8% of live births. Despite increases in survival of the most preterm, the incidence of complications such as chronic lung disease are increasing. There is evidence that preterm-born children have greater healthcare utilisation than term-born peers, for example in my PhD I demonstrated increased rates of paediatric intensive care admission.

The importance of multiple long-term health conditions (MLTCs) in children is now being recognised.

Previous studies suggest up to 10% of children have more than one chronic health condition, impacting on later health, education, and employment.

To our knowledge no studies have examined MLTCs in preterm-born children in early childhood. Previous studies of MLTCs examined either primary care or secondary care records, rather than using both. The Clinical Practice Research Datalink (CPRD) is derived from routinely-collected primary care data, with linked secondary care and pregnancy data, allowing researchers to follow patients across the healthcare system.

Objectives

We aim to investigate the impact of preterm birth on the development of MLTCs in childhood, through the following objectives:

Create CPRD cohort of children 0-10 years, with primary and secondary care data, and mother-baby linkage, identifying preterm and term-born children
Co-design MLTC definition for CPRD
Identify MLTCs in preterm and term-born children across primary/secondary healthcare
Describe the onset of MLTCs using multi-state models