Many premature babies in Europe are not being given the most effective lifesaving care, experts claim today.
Dr Jennifer Zeitlin of INSERM, Paris, France, and colleagues explain there are a few simple perinatal interventions which can improve survival and reduce neonatal morbidity.
They believe that different rates of uptake of these interventions could be causing the different levels of neonatal survival seen among European countries.
The researchers analysed figures on 850,000 births in 11 European countries. Of these, 7,336 infants were premature, that is, born between 24 and 32 weeks’ gestation. Babies with serious congenital anomalies or who did not survive to neonatal admission were excluded.
They also examined the use of four evidence based practices: delivery in a maternity unit with appropriate level of neonatal care; administration of antenatal corticosteroids; prevention of hypothermia; and measures to surfactant or continuous airway pressure to avoid lung problems.
Results showed that only 58% of eligible infants received all of these four practices. The likelihood of receiving all was lower for babies with a younger gestational age, growth restriction, low Apgar scores, and who were born the same day the mother was admitted.
Those who did receive all four had an 18% lower rate of in-hospital mortality or severe morbidity.
In today’s BMJ, the authors state: "This corresponds to an estimated 18% decrease in all deaths, without an increase in severe morbidity, if these interventions had been provided to all infants."
Commenting on the findings, Professor Peter Davis of the Royal Women’s Hospital in Melbourne, Australia, says: "The next step is to develop and test interventions to overcome this shortfall and ultimately improve outcomes."
Zeitlin, J. et al. Use of evidence based practices to improve survival without severe morbidity for very preterm infants: results from the EPICE population based cohort. BMJ 6 July 2016; doi: 10.1136/bmj.i2976 [abstract]
Leave a Reply