Supplementary memorandum from Professor
This further memorandum has been provided at
the request of Dr Chris Tyler in order to clarify the data presented
in my earlier evidence.
In my original evidence to the Committee I quoted
the figures which had been presented to the European Society for
Pediatric Research (Riley et al 2004).
In that analysis the denominator was all babies
admitted to the neonatal intensive care unit at UCLH within the
relevant time period. Hence those figures included infants born
at UCLH and infants born at other hospitals and transferred to
UCLH after birth. It is not possible to compare those figures
directly with the EPICURE data, because we did not have information
on all other babies born alive at all the other hospitals from
whom we received babies.
Hence for the benefit of the Committee I reanalysed
the data to look only at babies born at UCLH. The denominator
included all infants who were born at UCLH showing signs of life
on labour ward but who died before admission to the neonatal unit.
Hence the exact percentages are slightly different
from those quoted in my original evidence to the committee, although
the trend of the data is very similar. The fact the survival for
inborn babies is, if anything, slightly higher compared with the
analysis involving all babies is not in my opinion surprising.
There is a body of evidence suggesting that extremely preterm
babies who are born in major centres have a better outcome compared
with those who are transferred after birth from other hospitals,
and our data are consistent with this. In addition, the number
who were born alive at UCLH but not admitted to the neonatal unit
was small, a total of 5 out of 69 babies within the time period.
Hence their inclusion in the denominator did not make a large
difference to the overall percentages.