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Babies dying needlessly because of `poor care'.

Byline: John von Radowitz

PREMATURE babies may be dying needlessly because of inadequate standards of hospital care, a major investigation by paediatric experts concludes today.

The Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) carried out an in-depth study of the quality of care of babies born after 27 to 28 weeks of pregnancy.

Experts on the CESDI panel, set up by the Government to gather information on infant mortality,found a range of shortcomings which could be contributing to premature baby deaths.

In particular they identified inadequate numbers of skilled staff,and poor standards of ventilation and resuscitation.

Another serious deficiency was the haphazard movement of mothers with at risk pregnancies and premature babies between different hospitals.

Communication and record keeping were also found to be wanting.

The study looked at 3,522 premature babies born in England,Wales and Northern Ireland between 1998 and 2000.

Of these,88pc were still alive a month after birth. At least some of the remaining 12pcmight have survived too if standards had been better, the inquiry found.

CESDI member Dr Patricia Hamilton, consultant neonatologist and honorary secretary of the Royal College of Paediatrics and Child Health, said: ``I think there is potential for reducing mortality - we certainly need more specialist nurses.

``This study has shown that these babies do need close supervision. They are very fragile and need close monitoring and rapid responses. What we are saying is not a reflection on individual staff,it's more a systems problem.''

In 1999,Britain had the second highest infant mortality rate in the European Union after Greece - 5.8deaths per 1,000 live births. The lowest was Sweden, with 2.9deaths per 1,000. Britain also has the highest rate of premature birth in Europe.

Death rates for babies weighing less than 1000 grams (2lbs 2oz)have dramatically improved since 20 years ago, when only 20pc survived. Today, the survival rate is about 80pc,.

The CESDI investigation found that a tenth of babies were transferred between hospital units in the first week of life.

But disorganisation in the way babies and mothers were moved around put ``both mother and baby at risk''.

The report called on the Department of Health to support the establishment of managed clinical networks to improve referrals and transport.

Dr Mary Macintosh,director of CESDI, said: ``The transfer of mothers before labo ur and babies during the first week of life can be ad- hoc and precarious. Neonatal intensive care resources should be used more effectively.

``There is a pressing need for national standards to be introduced to ensure appropriate referral and transfer arrangements that are safe for both mother and baby.''

The premature baby charity BLISS called for immediate action to upgrade hospital services.

A spokeswoman said: ``It is unacceptable that mothers and babies are still being put at risk because the right systems and services are not in place.''

The Department of Health said new guidelines had either been issued or commissioned in response to CESDI findings.
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Publication:Daily Post (Liverpool, England)
Date:Mar 24, 2003
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