1. Please affix EPICure study bar-coded label here Examination of the umbilical cord for signs of inflammation Procedures following all births 22 0 – 26 6 weeks gestational age during 2006 Any specimen sent for pathological examination should be labelled with an EPICure label and sent to the pathologist together with this form, 2 spare EPICure bar-coded labels and a Histopathology Freepost label in addition to your standard hospital label and request form Labour Ward 1.If you routinely send placenta and membranes to the pathologist please also send this form and EPICure labels as indicated above 2.OR If you don’t send them routinely, please send them for this birth 3.OR If this is difficult please send a piece of cord, about 10cm from the baby end, to the pathologist in formalin in a universal container with this form and EPICure labels Please don’t forget to indicate on the EPICure Labour Ward Log form what you have done Dear Pathologist The research team has sent letters about the study to pathologists they believe are likely to receive this material so we hope you already know about it. If you don’t we apologise; some information is available on the reverse of this card. We hope you will be able to process a piece of umbilical cord about 10 cm from the fetal end to a paraffin block, label the block with the EPICure number that is on the bar-code label and send it to Dr Helen Porter, Consultant Paediatric Pathologist in Leicester at FREEPOST HISTOPATHOLOGY EPICURE 2 If this is not possible we would be grateful if you could retain a piece of cord in formalin and the study team will make arrangements to collect it at the end of the recruitment period. EPICure 2 A study of extreme prematurity in 2006

2. EPICure 2 is a population based study of outcomes of extreme prematurity. The study team is aiming to collect information about all births in the gestational age range 22 0 – 26 6 weeks in all English maternity units during 2006. The study is funded from a Programme Grant awarded by the Medical Research Council that supports a number of studies about extreme prematurity, including continued follow up of the national cohort recruited by the same research team in 1995. The principal aims of EPICure 2 are to measure major survival and morbidity in 2006 and to compare with findings in 1995 and at the same time to collect increased clinical information describing complications and management around the time of birth to study associations with later outcomes. Funding is available for follow up of this cohort. The study, including the collection of a piece of umbilical cord is approved by the East London Research Ethics Committee 05/Q0605/107 and has been registered with the NHS R&D departments of all the participating NHS Trusts. The study team have permission to use clinical data collected from routine sources without explicit consent from bereaved parents: PIAG 3-07(f)/2005. Parents of babies who survive to go home will be asked to give consent for the study team to link neonatal data including the results of umbilical cord examination to paediatric outcomes. More information is available on the study website at www.epicurestudy.com or from the Principal Investigator for the perinatal data collection, Professor Kate Costeloe via Kerrie.Montoute@homerton.nhs.uk. www.epicurestudy.com Kerrie.Montoute@homerton.nhs.uk