Onsite NICU care for very premature babies may reduce brain damage risk

Posted on October 17, 2019

New research published today shows that if an extremely premature baby (under 28 weeks) is born in a hospital that has a Neonatal Intensive Care Unit (NICU) – the most specialist care available – onsite, they may have a reduced risk of brain damage and death.

Over 17,000 babies cared for in England were included in this large-scale study which adds extra weight to previous research which has shown a connection between place of birth for the most vulnerable babies and their outcomes. The paper found that:

  • 27.5 per cent of babies who were transferred to a different hospital within 48 hours were recorded as having a severe brain injury, compared to 14 per cent of babies who were born at a hospital with a NICU onsite.
  • The results also suggest there may be an increased risk of death as well, with 26.3 per cent of babies being cared for in a hospital without a NICU dying compared to 21 per cent of babies cared for in a hospital with a NICU.

Neonatal services and neonatal transport teams in England are already working hard towards ensuring that all extremely premature babies are born in a hospital where they can receive this specialist care as soon as they are born.

In 2017 The National Neonatal Audit Programme (NNAP) found that three in four of these babies were born in the right place.

Justin Irwin, Chief Executive of the premature and sick baby charity Bliss, said: "In order for every baby to have the best chance of survival and quality of life they must be born in a hospital that has the right level of neonatal unit for their needs.

"This study adds significantly to our understanding of how critical it is for extremely premature babies in particular to be born at a hospital with Neonatal Intensive Care Unit (NICU) onsite.

"It shows that babies born earlier than 28 weeks at a hospital without a NICU are at significantly increased risk of dying or sustaining a severe brain injury. While most babies born in the UK at 27 weeks or under are delivered at a hospital with a highly specialist unit onsite, one in four are not.

"We are pleased that work is ongoing across England to improve outcomes for extremely premature babies, and that the importance of being born in the right place has been recognised. However, it is critical that the Government and NHS maintain this momentum and ensure that enough resources are available to make sure every baby receives the care they need at the right place and at the right time."