The sixth MBRRACE-UK collaboration’s annual report Saving Lives, Improving Mothers’ Care led by the National Perinatal Epidemiology Unit shows that the number of women dying as a consequence of complications during or after pregnancy remains low in the UK - fewer than 10 of every 100,000 pregnant women die in pregnancy or around childbirth.
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Charles Roehr has joined the NPEU as CTU Clinical Director.
Charles is a neonatal intensivist and clinical scientist, and Associate Professor of Paediatrics at the University of Oxford. He was previously (2014-2019) clinical consultant neonatologist at the John Radcliffe Hospital, NHS Foundation Trust in Oxford, UK. His special interest is neonatal stabilization/ resuscitation and non-invasive respiratory support. Charles is a Fellow of the Royal College of Paediatrics and Child Health, UK and Research Fellow at Green Templeton College, Oxford.
The results of the SIFT randomised controlled trial have been published in the New England Journal of Medicine.
Each year, over 8,000 babies are born very prematurely (more than 8 weeks before their due date) in the UK and the best way to feed these babies in early is not known. How these babies are fed affects short and long-term health outcomes, health-care costs and resources, so it’s an important issue for the NHS and other health services across the world.
The SIFT trial asked, “Does a faster increase in the daily rate of milk feeds, compared with a slower increase, result in better health outcomes and reduced use of hospital resources?”
Between June 2013 and June 2015 we recruited 2,804 infants born very preterm or with very low birth weight and followed up to 2 years of age. Half of them received faster increments of milk feeds and half of them were given slower increments.
The results showed no difference in survival without moderate or severe developmental disability at 2 years of age. The speed of increment in feeding also did not affect the risk of infection, bowel problems or growth before the babies were discharged from hospital. Faster feeding reduced the number of days to reach full milk feeding and the number of days the babies were fed through a tube, but the risk of moderate to severe motor disability was unexpectedly higher at 2 years in babies who received faster increments of milk feeds.
You can read more about the findings of the SIFT trial in the NEJM.
A study by Kate Fitzpatrick (lead author), Jennifer Kurinczuk and Maria Quigley from the NPEU, and Sohinee Bhattacharya, investigating the short-term outcomes of mothers and babies following a previous caesarean section has had quite a bit of media coverage over the past week.
The study was published on 24th September 2019 in PLOS Medicine in an article titled, Planned mode of delivery after previous cesarean section and short-term maternal and perinatal outcomes: a population-based record linkage cohort study in Scotland.
BBC News featured this study in a health article titled Repeart Caesareans 'often safer birth option'.
Kate was also interviewed (1:09:40) by Jeremy Vine on his BBC radio 2 show: Boris Johnson and C-sections.
You can read more about this on the Nuffield Department of Population Health website
A large team from the NPEU Clinical Trials Unit will be heading to Brighton for the 5th International Clinical Trials Methodology Conference (ICTMC 2019) from 6 to 9 October.
Several of the team will be presenting at the conference; Associate Professor Ed Juszczak will be speaking on ‘Introducing the extension of the CONSORT 2010 Statement for the reporting of multi-arm parallel-group randomised controlled trials’ and Trial Statistician Jennifer Bell will be talking about ‘Setting up a stopping boundary for safety in a phase II trial’.
From the SIFT trial, we also have a number of different posters being presented.
Madeleine Hurd will be presenting ‘Managing follow-up among parents of very pre-term infants: methods to improve questionnaire response rate’ and Ed Juszczak will present the ‘Evaluation of the effectiveness of an incentive strategy on the questionnaire response rate in parents of premature babies’.
If you are visiting the conference, do please come along and say hi. Full details of all presentations are below:
Marian Knight, Professor of Maternal and Child Population Health from the NPEU recently appeared in a BBC News feature discussing the changes that need to be made in the future following the inequalities highlighted in the recent MBRRACE-UK collaboration's annual report, Saving Lives, Improving Mothers' Care.
We know that black women are much more likely to have severe complications than white women, so it's clearly a really important area to focus on and work out why. The difficulty is that there is no one easy answer, it's acutally a very complex picture.
As part of our programme of work, the NPEU will be undertaking indepth research focusing on the underlying reasons for these recent findings.
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