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Tuesday, 6 July, 1999, 03:58 GMT
Massive study into premature babies

Modern medicine can save more premature babies
Babies born after just 27 or 28 weeks of pregnancy are the focus of a huge investigation by paediatric experts.

Many babies are now born at this early stage, and, with modern treatments, nine out of 10 survive.


Doctors want to know why they cannot save some babies
However, the Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI), a body set up by the government to gather information on infant mortality, wants to learn more about why some babies survive - and some do not.

Its "Project 27/28" will look at every baby in England, Wales and Northern Ireland born after that period, and monitor survival.

Every labour ward will be equipped with a log book to record the progress of these vulnerable babies.

Dr Mary Macintosh, CESDI's Director, said: "Gestation at birth has not previously been collected nationally, and yet it is probably one of the most crucial data items needed.

"Prematurity is the single greatest contributor to neonatal deaths and morbidity, and the absence of gestational information precludes accurate descriptions of trends in survival."

Information vital

Some specialists are hoping that the information gathered will settle the debate over whether larger special care baby units in bigger hospitals produce better outcomes than those in smaller district hospitals, where the mother is much closer to the child.

Dr Tony Ducker, a consultant neo-natal paediatrician at the Medway Maritime Hospital in Kent, said: "There is a certain amount of evidence that bigger units going to be important, and certainly, below the age of 27 weeks, they have to go to the bigger units.

"It will be interesting to see whether the 27- and 28-week-old babies get the same results in different units

"When a baby doesn't survive, it's good to know from the outside what might have been done better."

Technology saves many

Two treatments have vastly improved the chances of survival of prematurely born infants.

If birth is predicted, steroid treatment given to the mother for 48 hours beforehand can be crucial.

And afterwards, surfactants, or soap-like substances, are given to help the baby's lungs expand, so it can breath unaided.

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