Ten years after birth, children born prematurely in France are generally in good health, but a notable proportion faces behavioral and academic challenges, sometimes requiring special care and support, according to a study by Inserm, France’s national institute for health research. The study, led by neonatologist Véronique Pierrat, shows that a significant number of premature children still have difficulties at age ten, which can affect their lives and those of their families, as well as the healthcare system. These findings align with similar studies conducted in other countries, and they highlight the need for continued support for this vulnerable group. The results reinforce the importance of France’s national strategy on neurodevelopmental disorders, which focuses on early detection and intervention, according to Stéphane Marret, a pediatrician and Inserm researcher. Since 2011, researchers from the Center for Epidemiology and Statistics Research (Inserm/Université Paris Cité) have been studying the long-term effects of premature birth in France, where about 7% of babies are born before 8.5 months of pregnancy. Their latest findings show that at age ten, 16% of premature children experience behavioral difficulties, such as trouble managing emotions or paying attention, compared to 12% of full-term children. Nearly half of extremely premature children—those born between 24 to 26 weeks of gestation—require at least one healthcare service related to developmental challenges, such as speech therapy or psychological support. This rate is about a third for moderately premature children (born between 32 to 34 weeks), showing that the earlier a child is born, the greater the risk for neurodevelopmental issues. The study, published in eClinicalMedicine, compared data from 2,181 premature children and 7,286 full-term children, collected through parent interviews. However, about half of the premature children initially surveyed were lost to follow-up by age ten. These missing children were often from socially disadvantaged backgrounds and likely had developmental challenges, meaning the study may have underestimated the true extent of difficulties. Researchers used statistical methods to adjust for this, but the issue remains a concern, according to Dr. Marret. Although most parents report their child’s health as “good” at ten, some note limitations in daily life, especially among extremely premature children. About 14% of them have trouble with daily activities, compared to 4% of moderately premature children, often linked to neurodevelopmental issues. These challenges extend to school and social life, with nearly one in four premature children needing special support at school—almost double the rate of full-term children. Premature children are also more likely to repeat grades and less likely to engage in social activities like sports or birthday parties. Charlotte Bouvard, founder of the association SOS Préma, emphasized that the effects of prematurity extend beyond the hospital, creating a “domino effect” that can place families in financial hardship and highlight regional disparities in care. While follow-up care is recommended for premature children up to age seven in France, it varies by region and resources, and moderately premature children are often excluded. Dr. Pierrat stressed the importance of personalized follow-up for all affected families. Dr. Marret noted that while prematurity is a key factor, other elements like psychosocial stress and family hardship also play a role. Pierre-Yves Ancel, head of the research team, called for new studies focusing on children born prematurely today, as societal and medical practices continue to evolve.