EPICure2 in hospital
This part of EPICure 2 looked at survival after birth at extremely low gestational ages (22 to 26 weeks of gestation) and described what happened to the babies when they were first in hospital.
We have already studied the occurrence of late terminations of pregnancy between 22 and 26 weeks of gestation and showed that the majority of these are carried out because the fetus has a malformation (See Draper et al BJOG 2012)
So far we have come up with some important findings, particularly when we compare what happened in 2006 with what happened in 1995 when we did our first study. The main conclusions in our first main paper (Costeloe et al BMJ 2012) are:
- Firstly, that the number of babies being admitted for care between 22 and 25 weeks of gestation has risen by 44% - nearly half as many again – between the two studies.
- Secondly, survival has improved for these babies by 13%, from 40% to 53% and more so at 24 and 25 weeks; although survival of babies born before 23 weeks remains very rare.
- Thirdly, that the care that mothers who are likely to deliver prematurely and that their babies receive has improved in that we are using more new treatments that have been shown to help babies
- Fourthly that, despite these improvements, the number of babies leaving neonatal units with abnormalities on their brain ultrasound scans, and with lung, bowel and eye problems are very similar to what we found in 1995.
We have other analyses underway:
- A study of the influence of antenatal factors on early neonatal outcomes
- A study of the role of the place of birth and transfer in determining outcomes
- A study of the influence of resources – cots, doctors and nurses – since 1995 – we have three surveys – 1996, 2006 and 2011 which will allow us to estimate the importance of such organisational factors on outcomes and to predict how changes since 2006 may have influenced outcomes; this is carried out in collaboration with Bliss, the premature baby charity, the British Association of Perinatal Medicine and the National Neonatal Audit Project.