The study, led by researchers at University College London (UCL) and University College London Hospitals NHS Foundation Trust (UCLH), suggests significant improvements in survival rates can be achieved when maternity and neonatal units have consistent staffing, resources and treatment policies.
The research shows that the overall rates of survival for infants born alive between 22 and 25 weeks of gestation and admitted to the neonatal unit at UCLH increased from 32 per cent to 71 per cent between 1981 and 2000. This includes babies born in other hospitals and transferred to UCH for intensive care.
The researchers also looked at the survival of infants born at the hospital between 1991 and 2000, including those born at 22-25 weeks gestation who died before they reached intensive care. The survival rate for this group at the end of the study period was 69 per cent – compared to 71 per cent for the group that included only babies admitted to the neonatal unit. This suggests that the results were not solely a consequence of selecting infants with a higher chance of survival.
The study was conducted by Professor John Wyatt, a UCLH consultant and professor at the UCL EGA Institute for Women's Health, in conjunction with the hospital's neonatal team, and is part of a larger, ongoing follow-up programme for all extremely premature babies cared for at UCLH.
There are in the region of 670,000 births in the UK each year and approximately 90 per cent of infants are born on time, at between 37 and 42 weeks gestation. However, around eight per cent of births are 'preterm' and these infants are usually cared for in specialist neonatal units. Significant advances in neonatal medicine over the last 20 years mean that preterm infants have a better chance of survival, although some will have profound disabilities.
Dr Jane Hawdon, UCLH clinical director for women's health, said: "These results are down to the joint working of skilled and specialist teams in maternity and neonatal care including the establishment of perinatal networks so the right babies are cared for in the right place.
"UCLH significantly increased its resources for providing neonatal care between 1981 and 2000, which included employing more staff and bringing in state-of-the-art equipment. Technical advances in neonatal care – such as improved ventilation and nutrition – have also contributed, as has the close communication between the maternity and neonatal teams so you can plan the best time of delivery for mother and baby. Our facilities will improve even more later in the year when the trust opens phase two of the new University College Hospital which will include a dedicated maternal high-dependency unit and 17 neonatal intensive care cots."
During the study, of the 357 infants admitted to the neonatal unit at 22-25 weeks gestation, 163 (45 per cent) survived to discharge from the unit. 161 were alive for medical assessment at one year of age, which included a neurological examination, a developmental assessment and tests of visual and auditory function. Approximately one quarter of the infants showed signs of impairment leading to disability at one year of age – a figure which stayed fairly constant over the assessment period.
Commenting on the results, Professor Wyatt said: "The survival of extremely premature infants has been a matter of recent debate. A previous study of all extremely premature infants born alive in the UK and Ireland (the EPICure study) gave substantially lower survival rates than we report here, and it has been argued that there has been no improvement in survival across the country as a whole since EPICure was undertaken in 1995.
"However, studies which average the results from a large number of maternity units obscure the effects of very marked variations in resources, staffing and experience in the care of extremely premature infants. It is also plausible that ethical and clinical policies vary between different units and there is published evidence to show that this will have an effect on survival rates.
"We fully acknowledge that single centre studies such as this one have statistical limitations because of the relatively small numbers involved and they can also suffer from the problems of possible selection bias. However, they are hugely important because they provide information on the survival rates that can be achieved with consistent levels of staffing and resources, and with consistent policies. They also allow counselling of women who deliver at the hospital to be based upon data that are relevant to their individual situation."
Ruth Metcalfe | alfa
Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland
Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
20.03.2017 | Event News
14.03.2017 | Event News
07.03.2017 | Event News
23.03.2017 | Life Sciences
23.03.2017 | Power and Electrical Engineering
23.03.2017 | Earth Sciences