title: Risk determinants in early intervention use during the first postnatal year in children born very preterm.
abstract: BACKGROUND
  Early interventions (EI) are recognised for their potential risk-reduction capacity. Although developmental delay is common in children born very preterm reports continue to suggest poor uptake of EI services. This study examined the risk determinants of EI in Australian children born less than 32 weeks gestation during the first year of life.
  
  
  METHODS
  As part of a multi-centre-randomised-trial, 195 children were prospectively studied during their first year of life and EI use, type of follow-up, perinatal, social and parental psychosocial risk factors were collected using questionnaires. Child neurodevelopmental disability-status was assessed at 12-months (cerebral palsy, blind, deaf, developmental quotient 1 standard deviation (SD) below mean). The associations between EI and variables were examined using Pearson's chi-squared test (χ2) and regression techniques.
  
  
  RESULTS
  A total of 55% of children received EI, 51% attended post discharge neonatal intensive care unit (NICU) and the remainder attended exclusive primary health care. Risk factors included, 50% perinatal, 19% social and 34% psychosocial and at 12-months 23% were categorised as disabled. Low social risk and NICU follow-up attendance were significantly associated with EI use but only perinatal risk (OR 3.1, 95% CI 1.7, 5.6, p = <0.01) and disability (OR 2.2, 95% CI 1.1, 4.7, p = 0.04) independently predicted EI use.
  
  
  CONCLUSIONS
  It is reassuring that children with perinatal risk receive EI, opportunity remains to improve EI uptake in families with social and parental psychosocial risk during the first year of life.
authors.affiliation: Women's and Newborn Services, Royal Brisbane Women's Hospital, Herston 4029, Australia. m.pritchard@uq.edu.au.
authors.forename: Margo A
authors.initials: MA
authors.lastname: Pritchard
authors.forename: Paul B
authors.initials: PB
authors.lastname: Colditz
authors.forename: David
authors.initials: D
authors.lastname: Cartwright
authors.forename: Peter H
authors.initials: PH
authors.lastname: Gray
authors.forename: David
authors.initials: D
authors.lastname: Tudehope
authors.forename: Elaine
authors.initials: E
authors.lastname: Beller
mesh_terms: D002662:Child Health Services; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology; D019988:Children with Disabilities; D018479:Early Intervention, Educational / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D015337:Multicenter Studies as Topic; D010351:Patient Discharge; D011320:Primary Health Care; D011446:Prospective Studies; D011793:Queensland; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires