Intended for healthcare professionals

Letters Improving outcome in very preterm infants

Authors’ reply to Page and Rafi

BMJ 2016; 354 doi: (Published 31 August 2016) Cite this as: BMJ 2016;354:i4671
  1. Jennifer Zeitlin, senior researcher1,
  2. Bradley N Manktelow, senior lecturer in medical statistics2,
  3. Aurelie Piedvache, statistician1,
  4. Marina Cuttini, perinatal epidemiologist3,
  5. Elaine Boyle, senior lecturer in neonatal medicine2,
  6. Arno van Heijst, director4,
  7. Janusz Gadzinowski, professor and chair of department5,
  8. Patrick Van Reempts, professor of paediatrics and chair of department6,
  9. Lene Huusom, consultant obstetrician and gynaecologist7,
  10. Tom Weber, consultant obstetrician and gynaecologist7,
  11. Stephan Schmidt, professor of obstetrics8,
  12. Henrique Barros, professor of epidemiology9,
  13. Dominico Dillalo, public health doctor10,
  14. Liis Toome, head and researcher11,
  15. Mikael Norman, professor of paediatrics and neonatal medicine12,
  16. Beatrice Blondel, senior researcher1,
  17. Mercedes Bonet, researcher1,
  18. Elisabeth S Draper, professor of perinatal and paediatric epidemiology2,
  19. Rolf F Maier, director of the children’s hospital and paediatrics chair13
  1. 1INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, 75014, France
  2. 2Department of Health Sciences, University of Leicester, Leicester, UK
  3. 3Clinical Care and Management Innovation Research Area, Bambino Gesù Children’s Hospital, Rome, Italy
  4. 4Department of Neonatology, Radboud University Medical Centre, Nijmegen, Netherlands
  5. 5Department of Neonatology, Poznan University of Medical Sciences, Poznan, Poland
  6. 6Department of Neonatology, Antwerp University Hospital, Antwerp; Study Centre for Perinatal Epidemiology, Flanders, Brussels, Belgium
  7. 7Department of Obstetrics, Hvidovre University Hospital, Hvidovre, Denmark
  8. 8Department of Obstetrics, University Hospital, Philipp University of Marburg, Germany
  9. 9EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
  10. 10Health Department, Regione Lazio, Rome, Italy
  11. 11Unit of Neonates and Infants, Tallinn Children’s Hospital, Tallinn, Estonia; University of Tartu, Tartu, Estonia
  12. 12Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institute, Stockholm, Sweden; Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden
  13. 13Children’s Hospital, University Hospital, Philipp University of Marburg, Germany
  1. jennifer.zeitlin{at}

We agree with Page and Rafi about the importance of identifying the key evidence based obstetric and neonatal interventions that can be monitored to assess quality of care for very preterm infants.1 2 As our study shows,3 evaluating the use and impact of four evidence based practices together sets higher standards and focuses attention on care processes. The EPICE (Effective Perinatal Intensive Care in Europe) project’s international dimension is a strength, as it reveals underuse of evidence based care in many health systems and cultures.

But international …

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