8.5 EPICURE 2: INTERVENTIONS TO STABILISE EXTREMELY PRETERM BABIES AT BIRTH

K. Costeloe¹, E. S. Draper², J. Myles¹, E. M. Hennesy¹. ¹Barts and the London School of Medicine and Dentistry, London, UK, ²University of Leicester, Leicester, UK

Background: Survival of liveborn babies at 23 weeks’ gestation in England is low at approximately 13% (EPICure2, unpublished data); this may reflect reluctance to stabilise and provide intensive care for these babies.

Objective: To record interventions at birth and to study differences between management at different gestations.

Methods: Details of signs of life and interventions at birth were recorded for all births 23 + 0 to 26 + 6 weeks in English hospitals in 2006.

Results: 1762 livebirths were recorded; 318 (18%) at 23 weeks. Although statistically fewer than at other gestations, nonetheless 83% of 23-week gestation infants were offered active support. Of these, similar proportions across gestations were intubated by 5 minutes and more extremely immature babies were given cardiopulmonary resuscitation and/or adrenaline. Good response, assessed by heart rate at 5 minutes was associated with increasing gestational age; there was an inverse relationship between gestational age and the proportion of deaths (see table).

Conclusions: These data refute the suggestion of systematic reluctance actively to resuscitate babies at 23 weeks’ gestation.

8.6 SEX-SPECIFIC DIFFERENCES IN CIRCULATING CARBON MONOXIDE AND THE INCREASED INCIDENCE OF HYPOTENSION IN MALE PRETERM INFANTS

M. J. Stark, …