ABSTRACT
Over the past half century, neonatal mortality (death in the first 28 days) has almost halved from around 15 per 1000 to 7 per 1000 live births. This is mainly due to improvements in maternal health and obstetric care, although advances in neonatal intensive care have contributed. Mortality in the most immature neonates remains high. The EPICure study examined outcome in all live births 26 weeks’ gestation in the UK and Ireland in 1995. This demonstrated overall survival of 6, 26 and 43 per cent in infants of 23, 24 and 25 weeks, respectively. The Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) was established in 1992 to collect information on all late fetal losses (20 weeks), stillbirths and infant deaths in England, Wales and Northern Ireland. This information is analysed regularly to try to establish ways in which these deaths might be prevented. CESDI project 27/28 reported patterns of practice or service provision that might have contributed to the deaths of premature babies at 27-28 weeks’ gestation over the period 1998-2000. This report recommended a number of changes for future practice including improved communication, documentation and staff training.
