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Abstract
Objective Currently used estimates of survival are nearly 10 years old and relate to only those babies admitted for neonatal care. Due to ongoing improvements in neonatal care, here we update estimates of survival for singleton and multiple births at 22+0 to 31+6 weeks gestational age across the perinatal care pathway by gestational age and birth weight.
Design Retrospective analysis of routinely collected data.
Setting A national cohort from the UK and British Crown Dependencies.
Patients Babies born at 22+0 to 31+6 weeks gestational age from 1 January 2016 to 31 December 2020.
Interventions None.
Main outcome measures Survival to 28 days.
Results Estimates of neonatal survival are provided for babies: (1) alive at the onset of care during the birthing process (n=43 763); (2) babies where survival-focused care was initiated (n=42 004); and (3) babies admitted for neonatal care (n=41 158). We have produced easy-to-use survival charts for singleton and multiple births. Generally, survival increased with increasing gestational age at birth and with increasing birth weight. For all births with a birthweight over 1000 g, survival was 90% or higher at all three stages of care.
Conclusions Survival estimates are a vital tool to support and supplement clinical judgement within perinatal care. These up-to-date, national estimates of survival to 28 days are provided based on three stages of the perinatal care pathway to support ongoing clinical care. These novel results are a key resource for policy and practice including counselling parents and informing care provision.
- Neonatology
- Mortality
Data availability statement
Data may be obtained from a third party and are not publicly available. Data may be requested from the data controller, the Healthcare Quality Improvement Partnership (HQIP). A Data Access Request Form can be obtained from https://www.hqip.org.uk/national-programmes/accessing-ncapop-data/%23.XQeml_lKhjU.
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Data availability statement
Data may be obtained from a third party and are not publicly available. Data may be requested from the data controller, the Healthcare Quality Improvement Partnership (HQIP). A Data Access Request Form can be obtained from https://www.hqip.org.uk/national-programmes/accessing-ncapop-data/%23.XQeml_lKhjU.
Footnotes
Contributors SES undertook the statistical analysis under the guidance and supervision of LKS. RA and BNM provided input to the statistical analysis and interpretation of results. ACF provided critical clinical input. JJK and ESD provided oversight and knowledge of the data sources. LKS and SES wrote the first version of the manuscript. All authors contributed to the interpretation, revised the manuscript critically and approved the final version for submission. LKS is the guarantor for the study.
Funding The MBRRACE-UK collaboration is commissioned by the Healthcare Quality Improvement Partnership (HQIP) to deliver the Maternal, Newborn and Infant Clinical Outcome Review Programme on behalf of NHS England, NHS Wales, Scottish Government, the Northern Ireland Department of Health and the States of Jersey Guernsey and the Isle of Man.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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