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Arquivos de Medicina

On-line version ISSN 2183-2447

Abstract

BARROS, Henrique et al. Effective perinatal intensive care in europe (epice): project description and first results in Portugal. Arq Med [online]. 2014, vol.28, n.6, pp.183-190. ISSN 2183-2447.

In the last decades, the improvement of antenatal and neonatal care led to a continued decrease in perinatal and infant morbidity and mortality, particularly for very preterm infants. However, there is a great variability in medical procedures and interventions across health units, both at national and international levels, which can result in avoidable inequalities in health outcomes. This study intends to describe (1) the European project “Effective Perinatal Intensive Care in Europe” (EPICE), designed to identify and understand such variation; (2) the pilot study conducted in the Northern Region of Portugal to test the protocol and the questionnaire for data collection and (3) the recruitment and final sample of the EPICE-Portugal cohort. The EPICE project includes 19 regions from 11 EU Member states and aims to explore how scientific knowledge is effectively applied to monitor very preterm infants, using both quantitative and qualitative methodologies. In Portugal, this study involves all the public maternity and neonatal intensive care units from Northern and Lisbon and Tagus Valley (LVT) regions, along with 3 private units from LVT. The study procedures (recruitment and questionnaires) were tested in 4 hospitals in the Northern region of Portugal, by collecting information from the clinical records of 21 live births, born between May and December 2010. Data on pregnancy and prenatal care, childbirth, neonatal care and discharge was collected using a structured questionnaire. The pilot study tested data collection instruments and showed that, in general, the information documented in clinical records was enough to answer the questionnaire items, guaranteeing the feasibility of the EPICE project in Portugal. The EPICE-Portugal recruitment occurred between 1st june 2011 and 31st May 2012, identifying 724 very preterm live-births, as well as 95 terminations of pregnancy and 155 fetal deaths, from 22+0 to 31+6 weeks of gestation. The 724 live births resulted in 607 babies discharge alive, and written informed consent for the follow-up evaluations was obtained for 544 (89.6%) infants.

Keywords : epice project; perinatal care; infant; premature.

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