@article{Harnden:2023:10.1136/archdischild-2022-325157,
author = {Harnden, F and Lanoue, J and Modi, N and Uthaya, S and Battersby, C},
doi = {10.1136/archdischild-2022-325157},
journal = {Archives of Disease in Childhood: Fetal and Neonatal Edition},
pages = {540--544},
title = {A data-driven approach to understanding neonatal palliative care needs in England and Wales: a population based study 2015-2020},
url = {http://dx.doi.org/10.1136/archdischild-2022-325157},
volume = {108},
year = {2023}
}

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TY  - JOUR
AB  - ObjectiveTo quantify admissions to neonatal units in England and Wales with potential need for palliative care. Design, setting, and patientsDiagnoses and clinical attributes indicating a high likelihood of requiring palliative care were mapped to categories within the British Association of Perinatal Medicine’s (BAPM) framework on palliative care. We extracted data from the National Neonatal Research Database on all babies born and admitted to neonatal units in England and Wales 2015-2020.OutcomesThe number and proportion of babies meeting BAPM categories, their discharge outcomes, and the characteristics of babies who died during neonatal care but did not fulfil any BAPM category.Results12,123/574,954 (2.1%) babies met one or more BAPM category: 6,239/12,123 (51%) conformed to BAPM category 4 (postnatal conditions with high risk of severe impairment), 3,796 (31%) to category 2 (antenatal/postnatal diagnosis with high risk of significant morbidity or death), 1,399 (12%) to category 3 (born at margin of viability), and 288 (2%) to category 1 (antenatal/postnatal diagnosis not compatible with long-term survival); 401 babies (3%) met criteria for multiple categories. 6,814/12,123 (56%) were discharged home, 2,385 (20%) were discharged to other settings and 2,914 (24%) died before neonatal discharge. 3,000/5,914 (51%) babies who died during neonatal care did not conform to any BAPM category. Of these, 2,630/3,000 (88%) were born preterm.ConclusionsAt least 2% of babies admitted to neonatal units had palliative care needs according to existing BAPM categories; most survived to discharge. Of deaths, 51% were not captured by the BAPM categories; most were extremely preterm.
AU  - Harnden,F
AU  - Lanoue,J
AU  - Modi,N
AU  - Uthaya,S
AU  - Battersby,C
DO  - 10.1136/archdischild-2022-325157
EP  - 544
PY  - 2023///
SN  - 1359-2998
SP  - 540
TI  - A data-driven approach to understanding neonatal palliative care needs in England and Wales: a population based study 2015-2020
T2  - Archives of Disease in Childhood: Fetal and Neonatal Edition
UR  - http://dx.doi.org/10.1136/archdischild-2022-325157
UR  - https://fn.bmj.com/content/early/2023/03/22/archdischild-2022-325157
UR  - http://hdl.handle.net/10044/1/102190
VL  - 108
ER  - 

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