Characteristics of children requiring admission to neonatal care and paediatric intensive care before the age of 2 years in England and Wales: a data linkage study.

Objective: To quantify the characteristics of children admitted to neonatal units (NNUs) and paediatric intensive care units (PICUs) before the age of 2 years.

Design: A data linkage study of routinely collected data.

Setting: National Health Service NNUs and PICUs in England and Wales PATIENTS: Children born from 2013 to 2018.

Tracking national neonatal transport activity and metrics using the UK Neonatal Transport Group dataset 2012-2021: a narrative review.

There are no internationally agreed descriptors for categories of neonatal transports which facilitate comparisons between settings. To continually review and enhance neonatal transport care we need robust categories to develop benchmarks. This review aimed to report on the development and application of key measures across a national neonatal transport service.

Estimated neonatal survival of very preterm births across the care pathway: a UK cohort 2016-2020.

Objective: Currently used estimates of survival are nearly 10 years old and relate to only those babies admitted for neonatal care. Due to ongoing improvements in neonatal care, here we update estimates of survival for singleton and multiple births at 22 to 31 weeks gestational age across the perinatal care pathway by gestational age and birth weight.

Design: Retrospective analysis of routinely collected data.

Diaphragm electrical activity during weaning of nasal high-flow therapy in preterm infants.

Objective: To determine whether electrical activity of the diaphragm (Edi) changes with weaning nasal high-flow (HF) therapy in preterm infants according to a standardised protocol.

Design: Prospective observational cohort study.

Setting: Neonatal intensive care unit.

Understanding ethnic inequalities in stillbirth rates: a UK population-based cohort study.

Objectives: To investigate inequalities in stillbirth rates by ethnicity to facilitate development of initiatives to target those at highest risk.

Design: Population-based perinatal mortality surveillance linked to national birth and death registration (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK).

Setting: UK.

Physiological effects of high-flow nasal cannula therapy in preterm infants.

Objective: High-flow nasal cannula (HFNC) therapy is increasingly used in preterm infants despite a paucity of physiological studies. We aimed to investigate the effects of HFNC on respiratory physiology.

Study Design: A prospective randomised crossover study was performed enrolling clinically stable preterm infants receiving either HFNC or nasal continuous positive airway pressure (nCPAP).

Variability in Very Preterm Stillbirth and In-Hospital Mortality Across Europe.

Background And Objective: Stillbirth and in-hospital mortality rates associated with very preterm births (VPT) vary widely across Europe. International comparisons are complicated by a lack of standardized data collection and differences in definitions, registration, and reporting. This study aims to determine what proportion of the variation in stillbirth and in-hospital VPT mortality rates persists after adjusting for population demographics, case-mix, and timing of death.

The evidence for high flow nasal cannula devices in infants.

High flow nasal cannula (HFNC) devices deliver an adjustable mixture of heated and humidified oxygen and air at a variable flow rate. Over recent years HFNC devices have become a frequently used method of non-invasive respiratory support in infants and preterm neonates that is generally popular amongst clinicians and nursing staff due to ease of use and being well tolerated by patients. Despite this rapid adoption relatively little is known about the exact mechanisms of action of HFNC however and only recently have data from randomised controlled trials started to become available.

Subspecialty neonatal trainees views on being prepared for the consultant role.

Higher specialist training offers an opportunity to focus on non-clinical skills as well as clinical issues. The authors wished to determine whether doctors who complete neonatal higher specialist training in the UK feel prepared for the consultant role with respect to management, research and teaching, as well as clinical activities. A questionnaire related to the preparedness of the consultant to carry out a range of activities was sent to all doctors who were appointed to the UK higher specialist training programme in neonatology from 2002 to 2008 who were currently working as consultants.

The state of neonatal transport services in the UK.

Neonatal transfer services across the UK have evolved at different rates, using a variety of approaches. Scotland, Northern Ireland and most recently Wales have adopted a more centralised approach than in England, where due to comparative population size transport services have developed alongside neonatal network boundaries. Despite considerable investment, transport provision remains variable in some areas and there are continuing issues common to most regions, including service provision and configuration, training, competencies and audit.

Who should staff neonatal transport teams?

Neonatal transport is variously staffed by diverse combinations of nurses, doctors and paramedical staff. There is no evidence that neonatal transport undertaken with staff from any particular professional background results in improved outcomes for infants; instead, it appears that beneficial outcomes result from using staff who are specifically trained in transport practice, regardless of their professional background. Core transport competencies that are transferrable should be a routine part of the training of transport team members.

Reduced anti-PRP antibody response to Hib immunisation in preterm (<32 weeks) UK infants who received inactivated polio (eIPV).

A vaccine containing inactivated polio (eIPV) (Pediacel) is now used in the UK. The effect of the eIPV on other components is not well understood. We studied Haemophilus influenzae type b (Hib) and tetanus responses in preterm infants, <32 weeks gestation at birth, immunised with the (then) standard UK primary vaccines and either oral polio vaccine (OPV) or eIPV and analysed the effect showing reduced Hib responses with eIPV.

Haemophilus influenzae type b immunization in infants in the United Kingdom: effects of diphtheria/tetanus/acellular pertussis/Hib combination vaccine, significant prematurity, and a fourth dose.

Objective: To measure anti-polyribosylribitolphosphate (PRP) antibody and anti-tetanus toxoid (TT) antibody responses in UK infants to explore the effects of (1) immunization with an acellular diphtheria/tetanus/pertussis/Haemophilus influenzae type b (DTPHib) combination vaccine, (2) significant preterm delivery, and (3) a fourth dose of conjugated Hib vaccine (PRP-T) in those with a low anti-PRP antibody (<1.0 microg/mL) after primary immunization.

Methods: A prospective study was conducted in 4 tertiary neonatal units at a time when 2 types of DTPHib vaccines were used interchangeably in the United Kingdom for primary immunization: acellular (DTPaHib) and whole cell.

Population-based outcomes after acute antenatal transfer.

Acute antenatal transfer to specialist centres is an accepted practice but few or no regular data are collected regarding the numbers of transfers performed or subsequent pregnancy outcome. We wished to determine the numbers, and the maternal and fetal outcomes following acute antenatal transfer between consultant obstetric units in the former Northern Region of the UK over a 12-month period (1 January-31 December 99). This is a geographically defined population in terms of provision of perinatal services.