Perinatal excellence to reduce injury in preterm birth (PERIPrem) through quality improvement.

Perinatal Excellence to Reduce Injury in Premature Birth (PERIPrem) is an 11-element perinatal care bundle designed to improve outcomes for preterm babies, in line with the National Health Service (NHS) Long Term plan. Designed in collaboration with 12 NHS Trusts (secondary care hospitals), South West and West of England Academic Health Science Networks, South West Neonatal Operational Delivery Network, parent partners and clinical experts, implementation was via bespoke quality improvement (QI) methodology. Before project initiation, there was regional variation in uptake of elements, evidenced by baseline audit.

Improving the environmental sustainability of paediatric care.

Accelerated global warming is directly related to greenhouse gas (GHG) emissions. In order to achieve international and national set targets on reducing GHG emissions, paediatricians should aim to decrease GHG emissions associated with paediatric care, when this is not in conflict with patient outcomes. In this article, we review literature on practical ways to encourage environmentally sustainable paediatric care and identify areas where more evidence is required.

Elevated International Normalized Ratio (INR) is Associated With an Increased Risk of Intraventricular Hemorrhage in Extremely Preterm Infants.

Introduction: The international normalized ratio (INR), a standardized method of reporting the prothrombin time, can be a surrogate marker of the vitamin K-dependent coagulation pathways.

Objective: To evaluate the relationship between INR measurements in the first 48 hours of life and subsequent development of intraventricular hemorrhage (IVH) in extremely preterm infants.

Materials And Methods: A single-center retrospective, observational cohort study of infants born at <28 weeks gestation.

Associations between early term and late/post term infants and development of epilepsy: A cohort study.

Background: While life-long impacts exist for infants born one or two weeks early little evidence exists for those infants born after their due date. However interventions could be used to expedite birth if the risks of continuing the pregnancy are higher than intervening. It is known that the risk of epilepsy in childhood is higher in infants exposed to perinatal compromise and therefore may be useful as a proxy for intrapartum compromise.

County lines: how gang crime is affecting our young people.

'County lines' is the term used for the proliferating mobile phone lines used by gangs to infiltrate county towns where a profitable drug market is identified. The National Crime Agency reports that 88% of police areas in England and Wales have either an established or emerging County Lines problem in their area. With an estimated 46 053 aged 10-18 years in England in a gang, the activities of gangs and County Lines have a devastating impact on young people, vulnerable adults and local communities.

Can infant sleeping bags be recommended by medical professionals as protection against sudden infant death syndrome?

Clinical scenario: A mother brought her infant to the hospital with bronchiolitis and incidentally asked if I would recommend the use of infant sleeping bags to protect against Sudden Infant Death Syndrome as several of her friends use them. Structured question: Can infant sleeping bags be recommended by medical professionals as protective against Sudden Infant Death Syndrome? Methods: A literature search was performed. Trials were included if they had an English version available and the papers examined the impact that sleeping bag use had on risk of SIDS or its risk factors.

Investigating the association between post-term birth and long term cognitive, developmental and educational impacts: a systematic review and Meta-analysis.

Infants who remain in-utero after their due date are exposed to increasing risk of infection, late stillbirth and delivery complications. Much of the current literature on post-term outcomes is based on short term observations and the impacts may be substantially greater in the long term. The aim of this work is to perform a systematic review and meta-analysis to quantify the cognitive or educational impacts of post term delivery.