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Travel time

For those who live and work in parts of the UK with mountains, scattered populations, and roads of variable quality, it has seemed intuitively likely that perinatal outcomes might be related to travel times to hospital. In Wales among 412,817 singleton births, there was indeed an increased risk of both early and late neonatal death in proportion to the travel time (Acta Paediatr 2014;103:e522–7). Importantly, the Welsh data related to travel time to the nearest hospital, not travel time to a hospital with maternity services, for which there was no increased risk of neonatal death. There did not appear to be an increased risk for intrapartum stillbirth, which is surprising but is in line with data from West Cumbria published by Parker et al 15 years ago in ADC. In these days when reconfiguration of maternity and paediatric services in England and Wales is high on the agenda, such data are an important counter-weight to the ‘shroud waving' model of argument against change.

Wrapping up babies

There is now no doubt that occlusive wrapping, applied immediately after birth to the smallest preterm babies, assists in preventing hypothermia. The drive …

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