Every year in the UK, 60,000 babies are born preterm, and these children are more likely to develop multiple long-term health conditions—but no one has tracked how these conditions accumulate across both GP and hospital records in early childhood. This matters because preterm birth affects 8% of live births, and while survival rates have improved, complications like chronic lung disease are rising. Previous studies have only looked at either primary care or secondary care records in isolation, missing the full picture of a child’s health journey. The researchers will use the Clinical Practice Research Datalink (CPRD), which links GP data, hospital records, and pregnancy information, to follow children from birth to age 10. If successful, this work could reveal when and how multiple health conditions first appear in preterm children, and how ethnicity and deprivation influence those patterns. That would allow healthcare systems to target monitoring and early intervention more precisely—potentially reducing the higher rates of intensive care admissions and long-term healthcare use seen in this group. The study is observational and descriptive, not an intervention, but it provides the foundational evidence needed to design better follow-up care for preterm-born children.
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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. Around 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. 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 - Stratify and adjust by ethnicity and deprivation - Describe healthcare usage of preterm-born children with MLTCs across primary and secondary care
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