Perinatal Optimisation and Stabilisation of the Preterm Infant

Perinatal Optimisation and Stabilisation of the Preterm Infant

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Workstream aims and background 

The optimisation workstream will aim to: 

  • Adopt and spread the preterm perinatal optimisation care pathway across England by 95% or greater by March 2026. 
  • The workstream aims to increase overall compliance with every component of the care bundle to 95% or greater by March 2026. 

Background: 

  • Prematurity is a major contributor to perinatal morbidity and mortality. 
  • Every year around one in 13 babies in the UK are born prematurely equating to around 60,000 babies being born before they have reached 37 weeks gestation. 
  • Neonatal Critical Care is a key element of NHS maternity provision, as collaboration to reduce pre-term labour or optimise outcomes if unavoidable is often required, whilst support for babies born prematurely, alongside care for others who are sick or have a medical problem following their birth is essential. 
  • Neonatal services and maternity services working together is a key element of the Maternity Neonatal Programme (MNP) with the inclusion of the recent Neonatal Critical Care Review (NCCR) resulting in a structured approach to improving the outcomes for women and babies throughout the antenatal, intrapartum and postnatal stages of care, where neonatal outcomes can often be significantly affected. 
  • Effective collaboration between Maternity and Neonatal Safety Improvement Programme (MatNeoSIP), Patient Safety Collaboratives (PSC) (via Patient Safety Networks), the Neonatal Operational Delivery Networks (ODN), Local Maternity Systems (LMS), as well as the Preterm birth Networks will ensure optimal outcomes and the delivery of high-quality care. 
  • Element 5 in Saving Babies Lives (Version 3.2) which forms part of safety action point six of the Maternity Safety Incentive scheme focuses on preterm birth and improvement in outcomes. 

  • Our impact so far

    From April 2020 to March 2025, up to 112 lives have been saved in the East Midlands with our support, by ensuring timely interventions are in place where problems could arise:

    • 1,076 mums giving birth at less than 30 weeks received magnesium sulphate within 24 hours before birth. This meant up to 29 babies will not develop cerebral palsy, transforming the lives of the children and avoiding lifetime care costs of up to £29M.
    • 517 mums in preterm labour at less than 34 weeks received antibiotics to reduce the risk of the baby developing early onset neonatal Group B Streptococcal infection, which can lead to sepsis or meningitis. As a result up to 51 babies in the East Midlands were born without Group B strep.
    • Up to 20 babies’ lives were saved thanks to mothers receiving antenatal corticosteroids – medication for women between 24 and 34 weeks of gestation where there is a risk of preterm birth – which helps lung development in the foetus, reducing the risk of breathing problems and other complications in newborns.
    • Up to 80 babies born at less than 34 weeks gestational age survived because their umbilical cord was clamped at, or after one minute after birth.

     

    Activity to date

    • Bringing regional stakeholders together.
    • Establishing the East Midlands Maternity and Neonatal Safety Network, which meets quarterly to facilitate shared learning and focus on the national safety priorities.
    • Signposting and support in using quality improvement methodology, tools and resources.
    • Supporting maternity and neonatal staff resilience, wellbeing and improvement leadership through webinars and resources.
    • Providing improvement coaching.
    • Offering bespoke safety culture discussions.

 

PeriPrem – local delivery 

In addition to the national programme, we are also supporting all sites in the East Midlands (alongside the EMNODN) on their delivery of the 11 elements of the PeriPrem bundle. 

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The PERIPrem (Perinatal Excellence to Reduce injury in Premature Babies) bundle outlines the 11 interventions that demonstrate a significant impact on brain injury and mortality of Preterm Babies. It also forms a unique opportunity for clinicians from Obstetrics, Midwifery and Neonatal Medicine to work together to drive forward and revolutionalise care for preterm babies.  

PERIPrem, launched by Health Innovation West of England and Health Innovation South West in April 2020, joined our Maternity and Neonatal Safety Improvement Programme from April 2021. Its continued success ensures its place in the programme as we enter the 2025/26 period. 

For more information see here.