Journal article
Change in early respiratory management of infants born at less than 30 weeks’ gestation in England and Wales: an observational cohort study
- Abstract:
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Objective
To describe changes in early respiratory support for infants born at <30 weeks' gestational age (GA) in England and Wales.
Design
Retrospective cohort study using data from the National Neonatal Research Database of all infants born at <30 weeks GA, admitted to neonatal units in England and Wales from 2016 to 2021.
Main outcome measures
Methods of respiratory support used in the delivery room and days 1 and 7 of care were determined. Success of the initial non-invasive respiratory support strategy was assessed by any use of mechanical ventilation in the first 7 days of care.
Results
24 107 babies were included. Use of continuous positive airway pressure (CPAP) and high-flow nasal cannula (HFNC) as the highest method of respiratory support for stabilisation increased during the study period (CPAP: 17.3% to 28.8%; HFNC: 0% (first recorded in 2016) to 0.7%). CPAP use increased in the most preterm (<25 weeks GA; 0.7% to 4.8%), the extremely preterm (<28 weeks GA; 7.2% to 17.5%) and the very preterm (28-29 weeks GA; 29.3% to 44.1%) cohorts. Among those initially stabilised with non-invasive ventilation in this study, 2763 (48.0%) infants required mechanical ventilation in the first week.
Conclusions
In England and Wales, use of non-invasive respiratory support for initial stabilisation has increased among babies born at <30 weeks GA. 48% of those stabilised with non-invasive ventilation required mechanical ventilation in the first week. A higher quality evidence base for interventions that reduce mechanical ventilation could improve respiratory management in this population.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
Access Document
- Files:
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-
(Preview, Supplementary materials, pdf, 481.8KB, Terms of use)
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(Preview, Accepted manuscript, pdf, 836.8KB, Terms of use)
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- Publisher copy:
- 10.1136/archdischild-2025-329495
Authors
+ National Institute for Health and Care Excellence
More from this funder
- Funder identifier:
- https://ror.org/015ah0c92
- Grant:
- NIHR303806
- Publisher:
- BMJ Publishing Group
- Journal:
- Archives of Disease in Childhood. Fetal and Neonatal Edition More from this journal
- Volume:
- 0
- Pages:
- F1–F6
- Place of publication:
- England
- Publication date:
- 2026-03-04
- Acceptance date:
- 2026-01-14
- DOI:
- EISSN:
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1468-2052
- ISSN:
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1359-2998
- Pmid:
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41781202
- Language:
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English
- Pubs id:
-
2385401
- Local pid:
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pubs:2385401
- Source identifiers:
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W7133556561
- Deposit date:
-
2026-03-26
- ARK identifier:
Terms of use
- Copyright holder:
- Farley et al.
- Copyright date:
- 2026
- Rights statement:
- © Author(s) (or their employer(s)) 2026. No commercial re-use. See rights and permissions. Published by BMJ Group.
- Notes:
- The author accepted manuscript (AAM) of this paper has been made available under the University of Oxford's Open Access Publications Policy, and a CC BY public copyright licence has been applied.
- Licence:
- CC Attribution (CC BY)
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