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Can we estimate the length of stay of very preterm multiples?
  1. Sarah E Seaton1,
  2. Elizabeth S Draper1,
  3. Keith R Abrams1,
  4. Neena Modi2,
  5. Bradley N Manktelow1
  6. on behalf of the UK Neonatal Collaborative
  1. 1 Department of Health Sciences, University of Leicester, Leicester, UK
  2. 2 Neonatal Data Analysis Unit, Section of Neonatal Medicine, Department of Medicine, Imperial College London, London, UK
  1. Correspondence to Dr Sarah E Seaton, Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK; sarah.seaton{at}

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In our recent paper1 we provided estimates of length of stay for very preterm (24–31 weeks gestational age) singleton babies admitted for neonatal care in units within England. As with much neonatal research, we chose to exclude multiples (twins, triplets and higher order; in this letter referred to as ‘multiples’) from this initial work. However, as around 1 in 10 twins are born before 32 weeks, compared with around 1 in 100 singleton births,2 it is important to be able to also estimate the length of stay for these babies to aid the planning of healthcare resources and facilitate the counselling of their parents.

We were interested in whether the estimates of length of stay from the singleton population could be applied to multiples without the need to calculate new estimates. Data related to multiples admitted to neonatal units in England equivalent to the singletons was extracted from the National Neonatal Research Database. A total of 7496 babies met the inclusion criteria as described elsewhere1: 6755 twins and 741 triplets or higher order.

We calculated the observed median (25th, 75th centiles) length of stay for multiples by week of gestational age at birth and compared it with that estimated previously for singletons (table 1). Across all gestational ages, the median length of stay for multiples was very similar to their singleton …

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  • Contributors SES conceived the idea and undertook the analysis, under the supervision of BNM, ESD and KRA. SES wrote the first draft of the paper. NM provided clinical context and medical insight. All authors contributed towards the manuscript, revising it critically for intellectual content. All authors have read and approved this final version of the manuscript.

  • Funding This study was funded by Research Trainees Coordinating Centre (grant number: DRF-2013-06-011, NF-SI-0512-10159).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Permission was granted to use anonymised data from the NNRD for research purposes (Reference: 14/NW/0349, North West—Lancaster Research Ethics Committee) and agreement was obtained from all neonatal units in England that existed in 2014 to use their data for this project.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data used in this study can be obtained from the Neonatal Data Analysis Unit. More information can be found at:

  • Collaborators on behalf of the UK Neonatal Collaborative.