More severely premature babies survive
More babies born in England before 26 weeks are surviving but the proportion with serious health problems is unchanged
5th December 2012 - Research comparing statistics from England in 1995 and 2006 suggest more babies survived shortly after being born extremely prematurely in 2006 than in 1995. However, the number of severely premature babies with major health conditions on leaving hospital remained largely unchanged.
A second study, looking at the same time period, shows some improvement in the number of extremely preterm children who survived without disability at three years of age, but no change in the rate of serious health and developmental problems.
Taken together, these two large studies (known as the EPICure studies) suggest little progress has been made in reducing serious long term problems in extremely premature babies.
The authors say Information about the likelihood of survival and childhood impairments is important when discussing clinical decisions with parents.
Rates of preterm birth are rising in many European countries and are particularly high in the UK. Extremely preterm birth (before 26 weeks of gestation) is associated with high rates of death and, for those who survive, a range of problems with lifelong implications, requiring additional help from health, education and social services.
First study - short term outcomes
The first study reports survival and outcomes until initial discharge from hospital for babies born in 2006 at 22-26 weeks’ gestation and compares it with babies born at 22-25 weeks in 1995 and 2006. Serious conditions included lung disease, brain injury and retinopathy (a disease that can lead to loss of vision).
Between 1995 and 2006, the number of admissions to neonatal intensive care units of babies born at 22-25 weeks increased by 44%, from 666 in 1995 to 1,115 in 2006.
By 2006, survival shortly after birth increased by 13% (from 40% to 53%), but the proportion of survivors leaving hospital with major health problems was unchanged.
Despite the introduction of a range of interventions associated with improved outcomes, the authors say there was little evidence in 2006 that serious conditions have altered over the intervening 10 years.
These results suggest that the total number of children in the community with lifelong health problems as a result of extremely preterm birth will rise, and represents an important increase in workload for health, educational, and social services, they conclude.
Professor David Lomas, Chair of the Medical Research Council’s Population and Systems Medicine Board, which funded the two EPICure studies, said in a statement:"Almost half of babies born before 27 weeks will now pull through, and while many go on to do very well in the long term, a significant proportion will continue to need support throughout their lives to deal with the complications of their early arrival. Studies like EPICure are a very powerful tool as they allow us to follow health over a long period of time, informing future treatment strategies that improve the lives of patients."