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NICE launches bid to reduce premature birth rates

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The National Institute for Health and Care Excellence has published new guidelines designed to help the NHS reduce the number of babies born before full term.

In 2012, over 52,000 babies in England and Wales – about one in 10 – were born pre-term, according to data from the Office for National Statistics.

The new NICE guideline sets out the best treatment pathways for women at risk of, or in suspected or confirmed, pre-term labour.

“Preterm babies are at greater risk for conditions such cerebral palsy and delayed development”

Jane Norman

The guideline is aimed at healthcare professionals working in community settings, including home and free-standing midwifery units, and hospital settings such as obstetric units.

It said women at increased risk of pre-term labour, with suspected, diagnosed or established preterm labour, or who are having a planned preterm birth should be given– both oral and written – information and support as “early as possible”.

This should include information on the symptoms and signs of pre-term labour and explanations of the care that may be offered.

In addition, NICE said women who are having a planned pre-term birth should be provided with support that includes information about the likelihood of the baby surviving and other outcomes and risks, the neonatal care of pre-term babies and the immediate problems that can arise after birth.

There should also be ongoing opportunities for women who are having a planned preterm birth to talk about and state their wishes about resuscitation of the baby, and an opportunity to speak to a neonatologist or paediatrician, said NICE.

Meanwhile, it said intravenous magnesium sulfate for baby neuro-protection should be offered between 24+0 and 29+6 weeks of pregnancy, and considered for women between 30+0 and 33+6 weeks who are in established pre-term labour or having a planned preterm birth within 24 hours.

“Bliss wholeheartedly supports this new NICE guideline, which will be instrumental in improving outcomes for babies born prematurely and their mothers”

Caroline Davey

Other recommendations cover when to offer progesterone or a cervical “stitch” to prevent or delay the onset of pre-term labour, how to diagnose if a woman’s waters have broken prematurely and which antibiotics to offer, which drugs will help to delay labour and when to safely clamp and cut a premature baby’s umbilical cord.

Professor Jane Norman, director of the Tommy’s Centre for Maternal and Fetal Health at Edinburgh University, and chair of the committee that developed the guideline, said: “Pre-term birth is a common condition, affecting around 10 pregnant women in every hundred.

“This new NICE guideline describes the strategies that have been shown to be effective in reducing adverse outcomes, and which should be offered to all pregnant women at risk of pre-term birth,” she added.

Caroline Davey, chief executive of Bliss, said the premature and sick baby charity “wholeheartedly” supported the new guideline, adding that it would be “instrumental in improving outcomes for babies born prematurely and their mothers”.

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