National survey shows improved survival for extremely preterm babies born after 23 weeks
16 May 2008
Researchers have found that extremely premature babies born after 23 weeks had greater chances of survival in 2006 compared with 1995.
Epicure 2, a survey looking at all births before 27 weeks in England in 2006, was set up to look at overall survival rates and health outcomes for these very preterm babies and compare these to the findings of an initial survey, Epicure, carried out in 1995. The second survey and assessment of the first group of children at the age of 11 are funded by the Medical Research Council. Although the studies are similar, the 1995 survey only looked at babies born before 26 weeks, so the comparisons can only be made for these babies.
At present complete information is available for 92 per cent of babies admitted to neonatal units in 2006: these data have recently been presented to scientific meetings. Although some of the numbers in final reports of the second study will be different from those in this report the main messages will not change.
In 2006, 952 babies were born before 26 weeks and admitted to neonatal units in England, this represents an increase since 1995, of the number of babies being admitted of about 30 per cent. The overall survival rate for these babies was 52 per cent, an increase from 40 per cent since 1995, deemed highly statistically significant. Considering the results by each week of pregnancy those babies born at 25 weeks saw their survival rate rise from 54 to 67 per cent, while those born at 24 weeks saw their survival rate rise from 35 to 47 per cent; the changes in survival at both 25 and 24 weeks are statistically significant. Below 24 weeks there is a trend towards increased survival, from 19 to 26per cent but this does not reach statistical significance.
Professor Kate Costeloe, Consultant Neonatologist at Homerton Hospital, who led the study said: “It is extremely encouraging to see that more and more extremely preterm babies across England pull through. This is a tribute to the tremendous work of obstetricians and neonatal units.”
Although overall more extremely premature babies survived in 2006, the proportion of these children with serious brain abnormalities, 13 per cent, and still dependent on oxygen on their expected date of delivery, 74 per cent, remained unchanged from 1995.
Professor Costeloe continued: “Although many of these extremely preterm babies born before 27 weeks do well in the long term, a significant proportion suffer from severe complications of prematurity. These are challenging health problems and we hope the detailed data gathered describing the care of the mothers and of their extremely preterm babies will help us identify those interventions that are of benefit. This should help us to raise clinical practice and design future research studies aimed to improve outcomes further”
The data gathered in the survey showed no statistically significant improvement in the survival of babies born before 24 weeks between 1995 and 2006.
Professor Costeloe added: “The information gathered about the efforts made to resuscitate extremely preterm babies at birth makes it clear that staff are trying just as hard to provide care for the tiny babies born before 24 weeks. But these cases are simply more difficult and though about a quarter of these babies do pull through, they are more likely to have long term problems We hope this study will enable us to improve outcomes for these babies. It is important to bear in mind that many do very well and are able to become independent adolescents and adults.”
To listen to a podcast interview with Professor Kate Costeloe, click here.
Phone: 020 7670 5139
EPICure 2: Survival and early morbidity of extremely preterm babies in England: changes since 1995.
Kate Costeloe, Enid M Hennessy, Jonathan Myles, Elizabeth S Draper. At www.abstracts2view.com/pas [5365.1] (Free registration necessary).