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Four steps improve survival rate for premature babies

Use of all evidence-based practices could have saved 18% of deaths finds study

Four evidence-based care measures could significantly improve the survival rate of premature babies, say a team of international researchers.

Infants born before 32 weeks’ gestation have a high risk of death and serious illness compared with infants born at term, and although effective strategies exist to improve survival and reduce illness, it is not known how widely these are used in clinical settings.

To investigate the use of four widely available care measures known to improve survival, the researchers studied 7,336 infants born between 24 and 31 weeks. These babies were born without serious congenital anomalies and had been admitted to special care baby units in 19 regions of 11 European countries between 2011 and 2012. 

Crucial practices

The measures identified in the study included delivery in a maternity unit with adequate on-site neonatal intensive care facilities and giving antenatal corticosteroids to reduce complications of prematurity. It also identified preventing hypothermia and early treatment for breathing problems. 

The study found most infants received at least one of these evidence-based practices but only 58% received all four. The researchers calculated that if full evidence-based care had been provided to all the infants there would have been an 18% reduction in deaths.

The study said the findings ‘support the growing focus on bundling effective practices to improve processes of care and to achieve the best outcomes’. ‘Maximising the number of very preterm infants who receive the complete set of these well-proved practices could yield substantial gains in survival without increasing severe neonatal morbidity in survivors,’ it said.


Zeitlin J et al (2016). Use of evidence-based practices to improve survival without severe morbidity for very preterm infants: results from the EPICE population-based cohort. The BMJ. doi:10.1136/bmj.i2976

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