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Rapid response to:

Research

Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e7961 (Published 04 December 2012) Cite this as: BMJ 2012;345:e7961

Rapid Response:

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

27 August 2017
Malcolm John Dickson
Consultant Obstetrician & Gynaecologist
Wayside Cottge, Morley Green, Cheshire, SK9 5NZ