Objective Large-scale mortality trials require reliable secondary assessments of impairment. We compared the Ages and Stages Questionnaire (ASQ-3), a screening tool self-administered by parents, in classifying impairment using the ‘gold standard’ Bayley Scales of Infant Development (Bayley-III), a diagnostic tool administered by trained assessors. Design Analysis of 405 children around 2 years corrected age from the Australian Placental Transfusion Study, a trial conducted over 8 years. Setting Secondary analysis of international, open-label, multicentre randomised trial. Patients Children born <30 weeks gestation. Interventions Immediate (<10 s) versus delayed (60 s+) cord clamping. Main outcomes ASQ-3 and Bayley-III assessments around 2 years corrected age. Impairment (or developmental delay) was defined as <2 SD below the mean (<70) for Bayley-III domains. Results The area under the receiver operating curve for ASQ-3 domains predicting delay was 0.75–0.99. Sensitivity for predicting

Objective Size at birth is a key indicator of in utero growth. Our objective was to generate sex-specific percentiles for birth weight and head circumference in neonates born between 22 and 29 weeks gestation from pregnancies without hypertension or diabetes and assess differences between vaginal and caesarean births and between singletons and twins. Methods We used data from 12 countries participating in the International Network for Evaluating Outcomes in Neonates database from 2007 to 2021. We excluded data that were influenced by truncation with 1500g birth weight cut-offs in databases and neonates with major congenital anomalies or born to mothers with hypertension or diabetes. Results After exclusions, 132 727 neonates contributed to birth weight and 65 406 contributed to head circumference. The percentiles of birth weight were similar between countries at the 50th and 90th percentiles, though variability was noted in the lower percentiles from countries with smaller sample sizes

Neonatal outreach teams are essential to ensuring a safe and seamless transition for babies from the hospital to the community. Typically, outreach services support babies with additional medical needs, such as nasogastric tube feeds or home oxygen therapy. Studies report neonatal outreach helps to reduce mother-baby separation and length of hospital stay.1 2 As neonatal units face increasing pressure due to rising preterm birth rates and improving survival rates,3 the role of neonatal outreach has become increasingly vital in ensuring effective inpatient care pathways.4 There is currently no national guidance on the delivery of outreach care. This has led to variability in service …

Objective To assess the utility of a bespoke smartphone app to map noise and vibration exposure across neonatal road ambulance journeys. Design and setting Prospective observational study of ambulance journeys across a large UK neonatal transport service. Smartphones, with an in-house developed app, were secured to incubator trolleys to collect vibration and noise data for comparison with international standards. A case study exploring alternative routes between hospitals was undertaken. Results Over a 12-month period, the app was used to collect data from 1487 interhospital journeys totalling 81 925 km. Noise positively correlated with increasing vehicle speed. Noise exposure never fell below the recommended 45 dB(A) threshold for neonatal patients and exceeded 70 dB(A) for more than 60% of the time. During patient transfers, vibration would be classed as uncomfortable for healthy adults for 68% of journeys. Comparison of 111 journeys on two different routes between the same hospitals

Objective The objective is to evaluate changes in survival to discharge of liveborn infants less than 32 weeks’ gestational age (GA) in France, where the latest available data on very preterm survival at a national-level are from the EPIPAGE-2 (Etude épidémiologique sur les petits âges gestationnels) cohort in 2011. Design Population-based cohort study. Setting Metropolitan France in 2011, 2015 and 2020. Patients All births between 22 and 31 weeks’ GA using the EPIPAGE-2 cohort study for the year 2011 and hospital discharge data linked to death certificates from the Système National des Données de Santé for the years 2015 and 2020. Main outcome measures The primary outcome was survival to hospital discharge among liveborn infants. Survival rates were compared using modified Poisson regression and adjusted for population characteristics (maternal age, multiple birth, sex, small for GA). Data on all births were examined to assess changes to the live birth rate. Results Survival to discha

Objective Babies born between 27+0 and 31+6 weeks of gestation contribute substantially towards infant mortality and morbidity. In England, their care is delivered in maternity services colocated with highly specialised neonatal intensive care units (NICU) or less specialised local neonatal units (LNU). We investigated whether birth setting offered survival and/or morbidity advantages to inform National Health Service delivery. Design Retrospective national cohort study. Setting LNU, NICU, England. Patients UK National Neonatal Research Database whole population data for births between 27+0 and 31+6 weeks of gestation, discharged from/died within neonatal units between 1 January 2014 and 31 December 2018. We linked baby-level data to mortality information from the Office for National Statistics. Outcome measures Death during neonatal care, up to 1 year (infant mortality), surgically treated necrotising enterocolitis, retinopathy of prematurity, severe brain injury (SBI), bronchopulmona

Objective To evaluate if postnatal treatment with betamethasone in extremely preterm infants was associated with neurodevelopmental impairment (NDI) at 6.5 years of age. Design Prospective cohort study. Setting Extremely Preterm Infants in Sweden Study (gestational age <27 weeks, born 2004–2007). Patients 428 children born extremely preterm were assessed at 6.5 years of age, 115 treated with betamethasone and 313 not treated. Main outcome measures NDI at 6.5 years of age. Evaluation at 6.5 years included cognitive testing with the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), neurological examination and a medical record review. Exposure Treatment with postnatal betamethasone. Main outcome Moderate to severe NDI at 6.5 years of age, defined as a composite including cerebral palsy, and/or impairment in cognition, hearing and vision. Results Moderate to severe NDI was more prevalent in children treated with postnatal betamethasone (49% treated vs 26% not treated, p<0