Neonatal care recommendations for preterm babies could help save lives
A new study has set out a series of recommendations for improving care for babies born preterm and their families.
The study, funded by the National Institute for Health and Care Research (NIHR), highlights how current care for preterm babies varies across NHS trusts, despite existing guidance setting out a pathway to optimise care. It explores how this variation arises and makes recommendations for ensuring equitable delivery to help improve outcomes for all.
The PremPath research study, put together by health experts from the University of Leicester in conjunction with neonatal charity, Bliss, looked at how care for babies born prematurely (before 37 weeks of pregnancy) in England is working in practice.
The researchers have now released their findings to the Department for Health and Social Care to allow policy makers to consider taking next steps.
Recommendations include:
• Standardising maternity and neonatal data systems across England
• Reviewing processes to make sure families have equitable access to care, information and supportive resources
• Improving coordination between neonatal units and recovery/postnatal care
• Recognising the value of audit data, but also its limitations and potential unintended consequences for care delivery, and parent and staff experiences
• Clarifying responsibility and routine processes for counselling and preparing parents for preterm birth
• Reviewing infrastructure and processes to support delivery of place of birth policy
• Supporting further work on a more holistic approach to preterm care including psychological as well as clinical aspects
Professor Nicola Mackintosh
Nicola Mackintosh, Professor of Social Science Applied to Health at the University of Leicester, led the study alongside Dr Julie Roberts, Research Fellow in the Division of Public Health and Epidemiology’.
She said: “We know that prematurity is the leading cause of mortality for children under five. Babies born before 37 weeks continue to make up 75% of stillbirths and deaths in the first few of weeks of life. It’s a major contributor to ongoing health needs due to the risks of long-term neurodevelopmental health problems and adverse outcomes such as cerebral palsy and learning difficulties.
“Our study shows the importance of the pathway of care for preterm babies and provides examples of good practice in maternity and neonatal units. Our research also shines a light on the complexity of delivering good care and the implications of that for equitable care practices for mothers, birthing people and babies across the country. We have made recommendations to enhance care delivery so that we improve the lives of babies and families.”
Dr Julie Roberts added: “Our interviews with parents of preterm infants demonstrate the importance of supporting parent wellbeing while delivering the pathway of care effectively. The preterm birth of a baby is a difficult time for families and timely information, coordinated care, and parents’ involvement in their babies’ care can support wellbeing.”
Professor Mackintosh and Dr Roberts discuss their findings in a patient safety podcast available here, released by the NIHR Patient Safety Research Collaboration on World Patient Safety Day 2025 (17 September) – a WHO initiative to unite patients, families, caregivers, health workers, policymakers, and other stakeholders to foster collaboration and improve patient safety.This year, the theme focuses on paediatric patient safety to ensure safe care for every newborn and child.
Josie Anderson, Policy Research and Campaigns Manager from Bliss, and a co-applicant on the project said: ‘’Optimising care before, during and after preterm birth is essential for babies to have the best possible chance of survival and quality of life. This research demonstrates that too many opportunities are being missed to keep parents informed ahead of an early birth, involved in their baby’s care when admitted onto the neonatal unit, and to be well supported, especially regarding feeding their baby.
‘’For many parents of preterm babies, their baby’s birth and admission to neonatal care are completely unexpected. This can feel like a family’s entire world has been turned upside down. These findings present an opportunity to refine practices to ensure babies have the very best outcomes.”