Introduction to next year’s UKMidSS study: Neonatal Admission Dr Rachel Rowe Head of UKMidSS

Overview Background Methods Timetable Case definition Control selection Timetable

Background Why are we interested in neonatal admission? Guidelines recommend transfer when complications arise ~40% of adverse perinatal outcomes in births planned in midwifery-led settings occurred where no transfer took place Potential indicator of event where different management might have made a difference to outcome

Methods National case-control study Objectives To find out how many babies are admitted to a neonatal unit following birth in a midwifery unit To investigate risk factors for admission to a neonatal unit in babies born in a midwifery unit

Case definition Any woman who gives birth in the midwifery unit and whose baby: Is admitted to neonatal care within 48 hours of birth or before discharge home (whichever is sooner) OR Is stillborn or dies within 48 hours of birth without admission to neonatal care

Data collection Monthly reporting for 12 months Collecting data about cases and controls using OpenClinica Section 1. Woman’s details Section 2. Pregnancy/antenatal history Section 3. Labour and birth care Section 4. Baby care and outcomes

Control selection Who are our cases? Who are our controls? Any woman who gives birth in the midwifery unit and whose baby: Is admitted to neonatal care within 48 hours of birth or before discharge home (whichever is sooner) OR Is stillborn or dies within 48 hours of birth without admission to neonatal care The two women who gave birth in the midwifery unit immediately before the case, whose baby was NOT admitted to neonatal care etc.

Control selection summary For the Neonatal Admission Study Controls should be the two women who gave birth in the midwifery unit immediately before the case, whose baby was NOT admitted to neonatal care or die within 48 hours of birth Note that for this study it is more important that controls were women who gave birth immediately BEFORE the case If you are unsure, please check!

Timetable Piloting forms in OpenClinica November-December 2016 Sample forms on our website early 2017 Start data collection from 1st March 2017 First monthly report request 1st April 2017 Continue collecting data for 12 months Analysis and publication 2018

Thank you! Any questions or comments? ukmidss@npeu.ox.ac.uk https://www.npeu.ox.ac.uk/ukmidss @NPEU_UKMidSS This is independent research arising from a National Institute for Health Research (NIHR) Post Doctoral Fellowship awarded to Rachel Rowe (PDF-2014-07-006). The views expressed are those of the author and not necessarily those of the NHS, the NIHR or the Department of Health.