Select Committee on Science and Technology Written Evidence

Memorandum 53

Supplementary evidence from Professor John Wyatt

  As requested I enclose the abstract referred to in my oral evidence. For the benefit of the Committee and its advisors I have also presented summary data abstracted from our analysis. I have provided the numbers and percentage of infants born alive at University College London Hospitals who survived to one year of age. The period of study is 1996 to 2000. The data have been presented in the form most comparable to the original EPICURE study. The denominator includes all infants who were born showing signs of life on labour ward but who died before admission to the neonatal unit.
Gestational age (completed weeks) Number survived to 1 year of age Total born alive at UCLHPercentage survivors
2248 50
23613 46
241822 82
252026 77

  In the time period 1996 to 2000, 26% of survivors within this gestational age range had evidence of disabling impairments when examined at one year of age.

  A paper enclosing detailed description and analysis of these data will be submitted for publication in a peer-reviewed scientific journal shortly.

October 2007

Abstract, European Society for Pediatric Research, Annual Scientific Meeting 2004

Changes in survival and neurodevelopmental outcome in 22 to 25 week gestation infants over a 20 year period

K J Riley, S Roth, M Sellwood, J S Wyatt Department of Paediatrics and Child Health, University College London


  Advances in neonatal care have resulted in the survival of increasing numbers of extremely preterm infants. There have been concerns that the improved survival of infants born at the limit of viability has resulted in infants surviving with significant disability who would have previously died.


  To examine the change in survival over a 20 year period of infants born at less than 26 weeks gestation at a single tertiary referral centre and to correlate this with neurodevelopmental outcome at age one year.


  All infants without major congenital abnormalities born at less than 26 weeks gestation and admitted to University College London Hospitals neonatal unit between 1981 and 2000 were prospectively recruited for long term follow-up. At one year of age corrected the infants were recalled. Each child underwent a Griffiths Developmental Assessment and an Amiel-Tison neurological examination. Neurological status was then classified as normal, impairment without disability or impairment with disability. The data were divided into five year blocks for analysis.


  A total of 353 infants fulfilled the recruitment criteria and were enrolled into the study. Of these 190 died and 159 were recalled at one year of age. Data on four infants was not available. Survival to one year during the time periods 1981-85, 1986-90, 1991-95 and 1996-2000 was 32%, 34%, 46% and 71% respectively. The increased survival seen during the 1996-2000 period was statistically significant using Chi Squared analysis (p = 0.002).

  Statistical analysis of the Griffiths results was limited by modification of the test which resulted in restandardisation in 1996. This led to an overall reduction in the mean developmental quotient of 11 points in the normal population. For the infants in our study the mean total developmental quotient (DQ) during each of the time periods fell within the normal range. Values are shown in table 1. Analysis of the sub-scales revealed similar findings. The incidence of neurodisability was unchanged over the time periods (p=0.18). See table 1.

Table 1
YearGriffiths Total DQ(SD) Normal neurodevelopment No (%) Impairment without disability No (%) Impairment plus disability No (%)
1981-85105.0 (16.6) 12 (46%)9 (35%)5 (19%)
1986-90106.1 (17.6) 19 (55%)7 (21%)8 (24%)
1991-95103.9 (19.2) 8 (29%)9 (32%)11 (39%)
1996-200094.9 (16.2) 30 (57%)9 (17%)14 (26%)


  Our data show that despite a significant increase in the survival of infants born at less than 26 weeks gestation over a 20 year period there has been no significant increase in the incidence of adverse neurodevelopmental outcome in survivors.

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