Motol University Hospital

www.fnmotol.cz

The project is aimed at the target group of children with perinatal burden - their long-term monitoring associated with secondary and tertiary prevention. Over the last 20 years there has been a significant decrease in neonatal mortality in children and also in children with low and very low birth weight. Due to influences such as higher number of pregnancies in the older maternal age and after the artificial fertilization, there is an increase of the number of children born in a risk situation of the premature birth, complicated physiologic process of birth or the occurrence of congenital developmental disorders. Children burdened with the risk situation and possibly with the follow-up increased morbidity need an appropriate dispensary multidisciplinary care also over the next period of their lives. Providing this care, monitoring health and involving an early therapy will reduce the consequences and enhance the quality of life of the target group. Within the Multidisciplinary Care Centre project, there are concentrated at one unit the medical fields of paediatrics, neonatology, physiotherapy and neurology and in connection with it further outpatient specialists will be involved. 1/ Children released from neonatology division RICUs and ICUs will be monitored up to the age of 1 year. The assumption is 100 to 120 newly admitted children with perinatal burden. In collaboration with neonatology division physicians, the continuity of monitoring their health, psychomotor development, progress of vaccination, nutritional and food conditions will be ensured. Monitoring from the age of 3 months to the completed age of 12 months. At the same time there will be ambulatory examinations at specialists namely pursuant to the health conditions and needs of the child: examinations of eye and hearing, lung examination for respiratory distress, gastroenterology-examination following complications in the GI tract. Within the secondary prevention, these activities lead to early detection of child health problems and their therapy. After completing the 1 year age monitoring, the children will remain in the records of the Multidisciplinary Care Centre. 2/ Children with the significant morbidity, congenital disorders, developmental delay or multiple disabilities will continue to be invited for further examinations in the subsequent period. Centre´s paediatrician and relevant outpatient experts will also be involved in the monitoring. The children will also continuously receive the physiotherapy and ergotherapy care. Within the tertiary prevention, the families will be provided with counselling care to gain more confidence, and the help to find solutions in the social field. 3/ Examinations at the age of 2 years – children who at the age of 12 months reached the appropriate developmental level and have no other more serious problems. The examination by a paediatrician will focus on the evaluation of the morbidity, growth and will also aim at the development of the children. The children will undergo the Bayley Scales psychological examination, eye examination, eventually other examinations as needed. Based on the results and in cooperation with neonatology specialists, statistical data will be processed pertaining to the child anamnesis, morbidity and psychomotor development. This data is also forwarded to and then used by the national register. If it is proved necessary to support the further development, health conditions and prevent further complications, the 2 years old children will continue to be monitored in an intensive mode. 4/ Examinations at the age of 5 years - from 2015 we will focus on the examinations of 5 years old children from previous years. In the children we will monitor their health conditions as well as their growth and psychomotor development and the psychosocial conditions of the children. This is the age when it is being decided about their school maturity. With the timely examination we can achieve an intensive intervention in favour of mastering the skills associated with entering the school. Therefore, for reasons of the tertiary prevention, we consider it important to monitor these children. The number of the secondary and tertiary prevention programmes - 3 programmes, the number of children using the activities - a total of 200 -250 children.

Approximately 191 743 EUR