The Effective Perinatal Intensive Care in Europe (EPICE) cohort includes all births between 22 + 0 and 31 + 6 weeks of gestation in 2011/12 in 19 regions in 11 European countries. This cohort was set up to investigate the use of evidence-based interventions for prenatal and postnatal care of infants born very preterm (VPT) and to explore the associations between evidence-based care and their health and developmental outcomes. The first phase, ‘Effective perinatal intensive care in Europe’ (EPICE) focused on obstetric and neonatal care before and around the time of birth and during the neonatal hospitalization period, with follow-up at 2 years of corrected age (CA), while a second phase, ‘Screening for Health in Infants born very Preterm’ (SHIPS), assessed follow-up care provided in the first 5 years of life and neurodevelopmental outcomes at 5 years of age. Both phases were funded by the European Union [Seventh Framework Programme (FP7/2007–2013, No 259882; Horizon 2020 Research and Innovation Programme, No 633724].

Background: Studies are sparse and inconclusive about the association between maternal education and cognitive development among children born very preterm (VPT). Although this association is well established in the general population, questions remain about its magnitude among children born VPT whose risks of medical and developmental complications are high. We investigated the association of maternal education with cognitive outcomes in European VPT birth cohorts. Methods: We used harmonized aggregated data from 15 population-based cohorts of children born at <32 weeks of gestational age (GA) or <1500 g from 1985 to 2013 in 13 countries with information on maternal education and assessments of general development at 2–3 years and/or intelligence quotients between 4 and 15 years. Term-born controls (≥37 weeks of GA) were available in eight cohorts. Maternal education was classified as: low (primary/lower secondary); medium (upper secondary/short tertiary); high (bachelor’s/higher). Pooled standardized mean differences (SMDs) in cognitive scores were estimated (reference: high educational level) for children assessed at ages 2–3, 4–7 and 8–15 years. Results: The study included 10 145 VPT children from 12 cohorts at 2–3 years, 8829 from 12 cohorts at 4–7 years and 1865 children from 6 cohorts at 8–15 years. Children whose mothers had low, compared with high, educational attainment scored lower on cognitive measures [pooled unadjusted SMDs: 2–3 years = −0.32 (95% confidence intervals: −0.43 to −0.21); 4–7 years = −0.57 (−0.67; −0.47); 8–15 years = −0.54 (−0.72; −0.37)]. Analyses by GA subgroups (<27 vs ≥27 weeks) in children without severe neonatal morbidity and term controls yielded similar results. Conclusions: Across diverse settings and regardless of the degree of prematurity, low maternal education was associated with lower cognition.

This article reports the results of the European ‘DAFFODIL’’ (Dynamic Assessment of Functioning and Oriented at Development and Inclusive Learning) Project on the question of how functional and learning assessment systems facilitate or inhibit participation of children with developmental difficulties in inclusive education. Questionnaires were sent to medical, psychological, educational professionals, and parents in Sweden, Portugal, Hungary, Belgium, Romania, Norway, and the Virgin Islands. Interviews and focus groups were organized. Results (95%) showed that static standardized psychometric tests of intellectual, behavioural, and language functioning were mainly used, with the WISC-III being the most frequent test applied. Less than 5% of the 166 professionals in our sample used formative assessment and contextual observation to reveal learning or developmental potential in a process-oriented way. Experts were generally not satisfied with current assessment practices. Reported weaknesses included lack of time, human resources, materials, cooperation, and follow-up. Assessment practice was mainly used to determine whether a child should be placed in a special needs programme, a special school, or an institutional setting, depending on whether a country has inclusive education practice or not. Parents were satisfied with static functional assessment when its purpose was to obtain disability benefits (financial, special education resources, recognition), but were unhappy with the negative outlook of reports. The main complaint of teachers and parents was about the poverty of recommendations on how to work with the child. Our conclusion is that the current practice of standardized psychometric testing seems to contribute to barriers to learning if it is used in a deterministic or predictive way. In this regard, dynamic and functional assessment methods that are qualitatively oriented seem promising in addressing the issues of learning and development in a different way. The methods also contribute to an understanding of the child’s needs in learning and development. However, interpretation and communication of assessment results in a way that emphasizes a more adequate and challenging educational intervention for the child seems to be central.

Objectives To develop research priorities on the consequences of very preterm (VPT) birth for the RECAP Preterm platform which brings together data from 23 European VPT birth cohorts. Design and setting This study used a two-round modified Delphi consensus process. Round 1 was based on 28 research themes related to childhood outcomes (<12 years) derived from consultations with cohort researchers. An external panel of multidisciplinary stakeholders then ranked their top 10 themes and provided comments. In round 2, panel members provided feedback on rankings and on new themes suggested in round 1. Results Of 71 individuals contacted, 64 (90%) participated as panel members comprising obstetricians, neonatologists, nurses, general and specialist paediatricians, psychologists, physiotherapists, parents, adults born preterm, policy makers and epidemiologists from 17 countries. All 28 initial themes were ranked in the top 10 by at least six panel members. Highest ranking themes were: education (73% of panel members' top 10 choices); care and outcomes of extremely preterm births, including ethical decisions (63%); growth and nutrition (60%); emotional well-being and social inclusion (55%); parental stress (55%) and impact of social circumstances on outcomes (52%). Highest ranking themes were robust across panel members classified by background. 15 new themes had at least 6 top 10 endorsements in round 2. Conclusions This study elicited a broad range of research priorities on the consequences of VPT birth, with good consensus on highest ranks between stakeholder groups. Several highly ranked themes focused on the socioemotional needs of children and parents, which have been less studied.