Critical care level admissions and transfers of preterm births in England

Preterm birth, defined as delivery at gestational age less than 37 weeks, is a major contributor to neonatal morbidity, placing a significant burden on healthcare resources. This analysis explores the prevalence and patterns of critical care admissions among preterm neonates in England.

Hospital-level data were obtained from the Hospital Episode Statistics Data-NHS England 2022-2023 database. Data were analyzed for newborns in England for April 2022-March 2023, focusing on gestational age categories and the care level of facilities managing these infants.

Among all 541,765 singleton births in England during the examined interval, 7.0% (37,815) were preterm. Of these preterm infants, 71.3% (26,965) had a recorded gestational age. Of those with recorded gestational ages, 0.6% (149) were born <28 weeks (extremely preterm), 10.5% (2,844) at 28-32 weeks (very preterm), and 88.9% (23,972) at 33-37 weeks (moderate and late preterm). While 58.4% (87) of extremely preterm neonates were delivered in a hospital with appropriate facilities, 32.2% (48) of extremely preterm neonates, and 4.3% (121) of very preterm neonates were born in hospitals without neonatal intensive care facilities.

Persistent gaps in triage for women at risk of preterm birth highlights the need for improved early risk recognition and in utero referral systems to ensure appropriate delivery in recommended critical care facilities and to reduce postnatal transfers for babies.