Preterm counselling for parents
This page is intended to provide helpful information for paediatric doctors who are counselling parents about their preterm baby's chances of survival and longer-term outcomes. In combination with local hospital policies, the most useful information comes from the Epicure studies of preterm births in the UK.
The following graph from Epicure shows the overall outcomes from different stages in the pregnancy, from the start of labour, through birth to admission for neonatal care.
* ie excluding those where a decision was recorded not to intervene after birth;
§ numbers imputed from whole dataset.
Source: Epicure Overall Outcomes page - [link]
Survival at 22 weeks - 26 weeks
The following graph from both Epicure studies (1995/2006) shows survival for babies from 22 - 26 weeks. The second Epicure study (right hand column) broke down deaths into "no active care" (where a decision had been made to aim for comfort rather than resuscitation) and "intended care" (active resuscitation). Source: Epicure Survival Overview - [link]
Helpful factsheets and additional information
Bliss have produced some useful factsheets, including information about the Epicure studies, giving more detail about the long-term developmental consequences of prematurity. A couple of particularly helpful sheets include:
- Information on the EPICure Study 2 - Survival information from Epicure 2, summary of Epicure 1 at 11 years of age (education, IQ, school performance, special educational needs, early school entry etc).
The authors conclude: "We have identified a high likelihood of learning difficulties that contribute to school performance and educational needs of extremely preterm children. By 11 years of age, around 60 per cent of extremely preterm children require additional support in school and 33 per cent have a special educational need statement. The impact of these impairments is likely to increase over time and existing difficulties may be more evident in secondary school when cognitive demands increase in line with progressively harder studies. This may impact on the transition to secondary school."
- About neonatal care factsheet - Provides handy basic information for parents about arriving on NICU.