Study shows lack of care for premature babies

Hundreds of women with high-risk pregnancies are transferred between hospitals each year because of an acute shortage of intensive care cots for premature and sick babies.

Hundreds of women with high-risk pregnancies are transferred between hospitals each year because of an acute shortage of intensive care cots for premature and sick babies.

During one three-month period, 258 pregnant women had to be moved to another hospital because the specialist centre at which they were supposed to be treated did not have adequate resources, a study published today shows.

In a full year, this is equivalent to 1,032 high-risk women, who should be treated at one of Britain's 37 specialist perinatal centres, having to be transferred to a second hospital, or even a third.

The results, published in the International Journal of Obstetrics and Gynaecology, were condemned as unacceptable by clinicians from the British Association of Perinatal Medicine. "This study demonstrates a hazardous and unacceptable standard of care of high-risk mothers and their babies. Commitment to uphold clinical practice standards in perinatal care should be addressed as a NHS priority," said its president, Professor Andrew Wilkinson of Oxford University.

The study, between April and June 1999, found that 258 women were transferred because it was felt they were likely to deliver a baby that could not be cared for at the hospital they were at. Nearly 60 per cent of the women were in premature labour and the rest had illnesses that threatened their own health and required urgent delivery.

The typical journey time for the women, who were between 23 and 41 weeks pregnant, was 35 minutes, but the longest transfer took seven hours. Of the total, 61 per cent of women delivered at the receiving hospital, but 12 per cent had to be moved to a third hospital or were moved out of the main centre more than once. One mother delivered her 32-week baby at a motorway service station and nine women gave birth within one hour of arriving at hospital, five by natural deliveries and four by Caesarean sections.

Another mother, who delivered at 33 weeks, developed into an emergency case and had to be transferred back to her perinatal centre four days later. She died of kidney failure.

Of the babies who were delivered in the 57 receiving hospitals, six were stillborn and 71 per cent had to be admitted to an intensive baby care unit.

Dr Charlotte Bennett from John Radcliffe Hospital, Oxford, who was one of the researchers, said: "This study demonstrates the current shortfall in the capacity of high-risk perinatal services within the UK. An increased neonatal intensive care provision in the UK is required in order to uphold good clinical practice in the care of mothers and their infants."

The perinatal association said about 1,500 babies, most of whom were unborn, were transferred each year because the 37 specialist centres were full or had insufficient trained staff. "Perinatal centres within the UK do not currently have sufficient neonatal intensive care facilities, particularly trained neonatal nurses, to cope with demand," Professor Wilkinson said.

Bliss, the charity that supports parents of premature babies, said it had long been recognised that high-risk mothers and infants should be treated at specialist centres. Bengie Walden, the charity's chief executive, said the Department of Health had reviewed the "acknowledged inadequacies", but had not released the findings. "The Government should publish ... before any more babies die needlessly or are born prematurely at motorway service stations," he said.