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IMPROVING HEALTH FOR VERY PRETERM CHILDREN IN EUROPE

Published articles

Evidence-based neonatal unit practices and determinants of postnatal corticosteroid-use in preterm births below 30 weeks GA in Europe. A population-based cohort study
Nuytten A, Behal H, Duhamel A, Jarreau PH, Mazela J, Milligan D, Gortner L, Piedvache P, Zeitlin J, Truffert P on behalf of the EPICE (Effective Perinatal Intensive Care in Europe) Research Group
PloS One (2017)


Postnatal corticosteroids (PNC) were widely used to treat and prevent bronchopulmonary dysplasia in preterm infants until studies showed increased risk of cerebral palsy and neurodevelopmental impairment. We found that PNC are still frequently used in Europe, but with wide regional variation that was unexplained by neonatal characteristics. Even for infants at highest risk for PNC use, some regions only rarely prescribed PNC. A stated policy of reduced PNC use was associated with observed practice and is recommended.

See full article here: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0170234

Use of Magnesium Sulphate before 32 weeks of gestation: a European population-based cohort study
Wolf HT, Huusom L, Weber T, Piedvache A, Schmidt S, Norman M, Zeitlin J and the EPICE Research Group
BMJ Open (2017)


Magnesium sulphate has long been used in obstetric practice, but its current use is unknown. We aimed to explore reported policies of use of magnesium sulphate and the actual use in European obstetrical units by indication (eclampsia prophylaxis, fetal neuroprotection and tocolysis) in women giving birth before 32 weeks of gestation. We used data from the European Perinatal Intensive Care in Europe (EPICE) population-based cohort which is a large population-based multinational cohort.

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Patent ductus arteriosus treatment in very preterm infants: a European population-based cohort study (EPICE) on variation and outcomes
Edstedt Bonamy AK, Gudmundsdottir A, Maier RF, Toome, L, Zeitlin J, Bonet M, Fenton A, Børch Hasselager A, van Heijst A, Gortner L, Milligan D, Van Reempts P, Boyle EM, Norman M and collaborators from the EPICE Research Group
Neonatology (2017)


Spontaneous closure of patent ductus arteriosus (PDA) occurs frequently in very preterm infants and despite the lack of evidence for treatment benefits, treatment for PDA is common in neonatal medicine. We found that PDA treatment varies largely across Europen without associated variations in perinatal characteristics or neonatal outcomes. This finding calls for more uniform guidance for PDA diagnosis and treatment in very preterm infants.

See article here: https://www.karger.com/Article/Abstract/454798

Maternal Education Is Associated with Disparities in Breastfeeding at Time of Discharge but Not at Initiation of Enteral Feeding in the Neonatal Intensive Care Unit
Herich LC, Cuttini M, Croci I, Franco F, Di Lallo D, Baronciani D, Fares K, Gargano G, Raponi M, Zeitlin J; Italian Effective Perinatal Intensive Care in Europe (EPICE) Network
J Pediatr. (2016)


In this population-based cohort of very preterm infants, we found a significant and positive association between maternal education and the likelihood of receiving their mother's own milk at the time of discharge. In light of the proven benefits of maternal milk, strategies to support breastfeeding should be targeted to mothers with less education.

 See full article here: http://www.sciencedirect.com/science/article/pii/S0022347616311799

Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity
Emilija Wilson, RN, RM, Rolf F. Maier, MD, PhD, Mikael Norman, MD, PhD, Bjoern Misselwitz, MD, MPH, Elizabeth A. Howell, MD, PhD, Jennifer Zeitlin, MA, DSc, Anna-Karin Bonamy, MD, PhD on behalf of the show Effective Perinatal Intensive Care in Europe (EPICE) Research Group
The Journal of Pediatrics (2016)


Babies who are born very preterm, i.e. born two months or more before full term pregnancy, have limited resources to handle the cold environment right after birth. Despite well-known strategies on how to handle heat loss after very preterm birth, many have a body temperature below the desirable range 36.5-37.5°C, at admission to the neonatal intensive care unit.

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