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  • Journal article
    Modi N, Hanson M, 2020,

    Maternal, neonatal, and child health is essential for meeting SDG 3.4

    , LANCET, Vol: 396, Pages: 1731-1732, ISSN: 0140-6736
  • Conference paper
    Modi N, 2020,

    Preterm Nutrition in 2020: Breast Milk, Probiotics and Other Components

    , Publisher: KARGER, Pages: 404-405, ISSN: 1661-7800
  • Journal article
    Ewer AK, Deshpande SA, Gale C, Stenson BJ, Upton M, Evans C, Oddie SJet al., 2020,

    Potential benefits and harms of universal newborn pulse oximetry screening: response to the UK National Screening Committee public consultation

    , ARCHIVES OF DISEASE IN CHILDHOOD, Vol: 105, Pages: 1128-+, ISSN: 0003-9888
  • Journal article
    Jacob CM, Briana DD, Di Renzo GC, Modi N, Bustreo F, Conti G, Malamitsi-Puchner A, Hanson Met al., 2020,

    Building resilient societies after COVID-19: the case for investing in maternal, neonatal, and child health

    , LANCET PUBLIC HEALTH, Vol: 5, Pages: E624-E627, ISSN: 2468-2667
  • Journal article
    Yeo KT, Oei JL, De Luca D, Schmölzer GM, Guaran R, Palasanthiran P, Kumar K, Buonocore G, Cheong J, Owen LS, Kusuda S, James J, Lim G, Sharma A, Uthaya S, Gale C, Whittaker E, Battersby C, Modi N, Norman M, Naver L, Giannoni E, Diambomba Y, Shah PS, Gagliardi L, Harrison M, Pillay S, Alburaey A, Yuan Y, Zhang Het al., 2020,

    Review of guidelines and recommendations from 17 countries highlights the challenges that clinicians face caring for neonates born to mothers with COVID-19.

    , Acta Paediatrica: Nurturing the Child, Vol: 109, Pages: 2192-2207, ISSN: 1651-2227

    AIM: This review examined how applicable national and regional clinical practice guidelines and recommendations for managing neonates born to mothers with COVID-19 mothers were to the evolving pandemic. METHODS: A systematic search and review identified 20 guidelines and recommendations that had been published by 25 May 2020. We analysed documents from 17 countries: Australia, Brazil, Canada, China, France, India, Italy, Japan, Saudi Arabia, Singapore, South Africa, South Korea, Spain, Sweden, Switzerland, the UK and the USA. RESULTS: The documents were based on expert consensus with limited evidence and were of variable, low methodological rigour. Most did not provide recommendations for delivery methods or managing symptomatic infants. None provided recommendations for post-discharge assimilation of potentially-infected infants into the community. The majority encouraged keeping mothers and infants together, subject to infection control measures, but one-third recommended separation. Although breastfeeding or using breastmilk were widely encouraged, two countries specifically prohibited this. CONCLUSION: The guidelines and recommendations for managing infants affected by COVID-19 were of low, variable quality and may be unsustainable. It is important that transmission risks are not increased when new information is incorporated into clinical recommendations. Practice guidelines should emphasise the extent of uncertainty and clearly define gaps in the evidence.
  • Journal article
    Rees P, Stilwell PA, Bolton C, Akillioglu M, Carter B, Gale C, Sutcliffe Aet al., 2020,

    Childhood health and educational outcomes after neonatal abstinence syndrome: a systematic review and meta-analysis.

    , The Journal of Pediatrics, Vol: 226, Pages: 149-156.e16, ISSN: 0022-3476

    OBJECTIVE: To systematically review and meta-analyze the association between neonatal abstinence syndrome (NAS) and adverse health or educational childhood outcomes. STUDY DESIGN: An all-language search was conducted across 11 databases between 1/1/75, and 9/3/19, and 5865 titles were identified. Observational studies of children between 28 days and 16 years of age, in whom a diagnosis of NAS was documented, were included. Outcomes included reasons for hospital admissions, childhood diagnoses, developmental outcomes, and academic attainment scores. All studies underwent independent review by two trained reviewers, who extracted study data and assessed risk of bias using the Newcastle Ottawa Tool. RESULTS: Fifteen studies were included comprising 10,907 children with previous NAS and 1,730,213 children without previous NAS, aged 0-16 years. There was a strong association between NAS and subsequent child maltreatment (aOR 6.49 (4.46, 9.45, I2=52%)), injuries and poisoning (aOR 1.34 (1.21, 1.49, I2= 0%)), and a variety of mental health conditions. Studies consistently demonstrated an increased incidence of strabismus and nystagmus among those with previous NAS. Children with NAS also had lower mean academic scores than the control group in every domain of testing across age groups. CONCLUSIONS: NAS is significantly associated with future child maltreatment, mental health diagnoses, visual problems and poor school performance. Due to the necessary inclusion of non-randomized studies, incomplete reporting among studies and likely unadjusted confounding, this review does not suggest causation. However, we highlight associations requiring further investigation and targeted intervention, to positively impact the life course trajectories of this growing population of children.
  • Journal article
    Longford N, 2020,

    Performance assessment as an application of causal inference

    , Journal of the Royal Statistical Society Series A: Statistics in Society, Vol: 183, Pages: 1363-1385, ISSN: 0964-1998

    Institutions in health care, education and other public services are under constantpressure to perform to high standards and with efficiency. Assessment of theirperformance is often problematic because it either ignoresimportant backgroundvariables of their patients, students or clients (the case-mix), or adjusts for themin a way that is not equitable or transparent. We apply a methodof indirectstandardisationmotivated by the potential outcomes framework, in which weconsider the hypothetical scenario of an institution’s caseload being dispersed fortreatment throughout the domain of assessment (the country’s institutions). Thetarget of estimation is the difference of the means of the outcomes in the realisedand hypothetical settings. The method is applied to estimating the prevalenceof bronchopulmonary dysplasia (BPD) in extremely preterm-born infants in theneonatal units and their networks in Great Britain in 2017. The prevalence ofBPD is an audit measure in the UK National Neonatal Audit Programme.
  • Journal article
    Prior E, Modi N, 2020,

    Adult outcomes after preterm birth

    , POSTGRADUATE MEDICAL JOURNAL, Vol: 96, Pages: 619-622, ISSN: 0032-5473
  • Journal article
    Longford NT, Ramirez O, Giffe C, Longford NTet al., 2020,

    Causal models for monitoring the progress of infants with low birthweight

    , Revista Brasileira de Biometria -- Brasilian Biometric Journal, Vol: 35, Pages: 600-633, ISSN: 0102-0811

    We study the weight (body mass) of infants born prematurely and with lowbirthweight during the first postnatal year. The infants areenrolled in the Casa Canguroprogramme in Valle de Cauca, a department (province) of Colombia. The current weightand other physiological measurements are recorded at their visits to participating health-care facilities. We compare two groups of infants: those born at 31 weeks of gestationalage or earlier (extremely preterm) and those born at 33 weeks orlater (preterm). Thecomparisons are made using the potential outcomes framework, regarding the two groupsas treatments and selecting from them pairs matched on an extensive set of covariates.Matching is accomplished by propensity scoring. The outcomes (weight and height)at a particular age are approximated by interpolation.We conclude that the averageweight-handicap of the extremely preterm infants first increases, from about 600 gramsat birth to 900 grams on average at three months, and then is reduced, so that by thefirst birthday they are only about 250 grams lighter on average.
  • Journal article
    Webbe J, Gale C, 2020,

    NICE guidelines on neonatal parenteral nutrition: a step towards standardised care but evidence is scarce

    , The Lancet Child and Adolescent Health, Vol: 4, Pages: 645-646, ISSN: 2352-4642

    Globally, neonatal conditions are the leading cause of reductions in disability-adjusted life-years and affect outcomes that extend throughout life. Providing neonatal care to optimise such long-term outcomes is challenging because short-term research outcomes might conflict, even within individual trials. Evidence-based guidelines are a welcome tool to translate research into practice and reduce variation in care. Such standardisation of care can improve outcomes for patients. For example, adherence to a standardised guideline for enteral feeding is protective against necrotising enterocolitis, despite the heterogeneity in the content of the individual guidelines. The latest guideline by the UK's National Institute for Health and Care Excellence (NICE) on neonatal parenteral nutrition is a welcome addition to neonatal practice, and is particularly important given the deficiencies frequently found in the provision of neonatal nutritional care in the UK.

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