Significant improvement in neonatal care in England over 10 years
Neonatal services in England have seen a considerable improvement since the introduction of new guidelines in 2003, a study published on bmj.com claims.
The new guidelines were set out to help increase the proportion of premature babies born in a specialist care unit and reduce the amount of acute (within 24 hours of birth) postnatal transfers from one hospital to another. The specialised delivery and management of premature babies is associated with improved outcomes while acute postnatal transfer is associated with adverse outcomes.
Researchers from the Imperial College London looked at maternity units in England, Wales and Northern Ireland between 1998 and 2000 and units in England between 2009 and 2010.
They did find that the reorganisation has been met with some success: although the proportion of 27/28 week gestation babies born in a specialist care unit has increased, half are still delivered in non-specialist units, suggesting poor co-ordination between maternity and neonatal services. Furthermore, the proportion of babies transferred within 24 hours has increased and a third of multiple birth babies continue to be treated in separate units, showing a continuing inadequacy in cot capacity.
In relative terms, the proportion of babies delivered at specialist care centres improved from 18% to 49% between the first and second time frames (1998-2000 and 2009-2011), but the proportion undergoing transfer in England increased from 7%-12% for acute transfers and 18%-22% for late transfers. The survival of premature babies has improved between the two time frames, from 88% to 93%.
The authors conclude that two aims of the reorganisation are being realised: a higher proportion of babies are being born in specialist care units and are then being back-transferred to a neonatal unit nearer home when they no longer require highly specialised care. The authors argue however that co-ordination between maternity and neonatal services remains poor and that "future analysis of the wider population" will help to clarify the issues around the organisation of specialist newborn care.
Bliss Head of Programmes Jane Abbott said, "Bliss welcomes these findings which show that the introduction of managed clinical networks has brought about improvements in the delivery of neonatal care. It is very encouraging to see that more babies requiring specialist treatment are being born in units that can provide the right level of care. This reinforces the importance of managed clinical networks and their contribution to improving outcomes for babies born sick or premature. However, it is clear that investment into neonatal care and better coordination between maternity and neonatal services needs to be made a priority to ensure the best outcomes for all babies and their families."
In an accompanying editorial Dr Ciaran Phibbs from Stanford University School of Medicine says that although England has "made a good start on improving the regionalization of neonatal care", he feels it is necessary to expand efforts to include obstetric services so that all high-risk deliveries can be regionalised. He says that England still has a "long way to go" before the best possible outcomes for high-risk deliveries are achieved.
Provided by British Medical Journal
- Study shows increase in survival rates of extremely premature infants at London hospital Feb 01, 2008 | not rated yet | 0
- Discovery may bring special treatment for male babies Mar 25, 2008 | not rated yet | 0
- Surviving premature babies in Malawi continue to have poor growth rates and development delay Nov 08, 2011 | not rated yet | 0
- Neonatal intensive care units critical to infant survival Sep 01, 2010 | not rated yet | 0
- Lengthier treatment for very preterm babies has not improved survival rates Apr 21, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
The gap between life expectancy in patients with a mental illness and the general population has widened since 1985 and efforts to reduce this gap should focus on improving physical health, suggest researchers in a paper ...
Health 9 hours ago | not rated yet | 0
Failure to use linked electronic health records may lead to biased estimates of heart attack incidence and outcome, warn researchers in a paper published in BMJ today.
Health 9 hours ago | 5 / 5 (1) | 0
Dietary advice on added sugar is damaging our health, warns a cardiologist in BMJ today. Dr. Aseem Malhotra believes that "not only has this advice been manipulated by the food industry for profit but it is actually a risk ...
Health 9 hours ago | 5 / 5 (4) | 0
(HealthDay)—In 2008 to 2010, the prevalence of key health behaviors among U.S. adults varied, with about one in five adults current smokers and 62.1 percent overweight or obese, according to a report presented ...
Health 11 hours ago | 5 / 5 (1) | 0
(HealthDay)—The overall health of Americans isn't improving much, with about six in 10 people either overweight or obese and large numbers engaging in unhealthy behaviors like smoking, heavy drinking or ...
Health 11 hours ago | not rated yet | 0
(Medical Xpress)—Native peoples in regions where cameras are uncommon sometimes react with caution when their picture is taken. The fear that something must have been stolen from them to create the photo ...
16 hours ago | 4.2 / 5 (5) | 0 |
(Medical Xpress)—Despite spending billions of dollars on research and development, drug companies have been unable to come up with effective treatments for dementia and Alzheimer's Disease (AD). Now, A. ...
14 hours ago | 4.9 / 5 (11) | 0 |
Australian scientists have charted the path of insulin action in cells in precise detail like never before. This provides a comprehensive blueprint for understanding what goes wrong in diabetes.
16 hours ago | 4.6 / 5 (7) | 0 |
An experimental sleeping pill from US drug company Merck is effective at helping people fall and stay asleep, according to reviewers at the US Food and Drug Administration, which could soon approve the new drug.
9 hours ago | 3.7 / 5 (3) | 0
Activating an enzyme known to play a role in the anti-aging benefits of calorie restriction delays the loss of brain cells and preserves cognitive function in mice, according to a study published in the May ...
10 hours ago | 5 / 5 (4) | 0 |
A drug commonly used to treat depression and anxiety may improve a stress-related heart condition in people with stable coronary heart disease, according to researchers at Duke Medicine.
11 hours ago | 5 / 5 (1) | 0 |