Tamanna Moore research associate, Enid M Hennessy senior lecturer in statistics, Jonathan Myles research fellow in statistics, Samantha J Johnson lecturer (psychologist), Elizabeth S Draper professor of perinatal and paediatric epidemiology, Kate L Costeloe professor of paediatrics et al
Moore T, Hennessy E M, Myles J, Johnson S J, Draper E S, Costeloe K L et al.
Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies
BMJ 2012; 345 :e7961
consider the Context of prematurity
It is very good news the outcome of infants born at the extremes of prematurity has markedly improved. However, one has to exercise caution using these outcome statistics when counselling parents giving birth extremely prematurely.
What is rarely considered are the reasons for premature delivery, and how that impacts on outcomes, as well as the gestation. Prolonged rupture of membranes with ascending infection, or a massive placental abruption will cause direct damage to the fetus. Where as a baby born as a result of cervical incompetence from previous cervical surgery is not harmed by the causation of the premature labour.
When considering outcomes, it is rare for single parameters to give personalised outcomes, and when we try to do so, we must need to consider the context of the prematurity, as well as the gestation
Competing interests: No competing interests