Multiple births and neonatal care report

By Julie Griffiths on 21 November 2017 Neonatal Care Multiple Birth Tamba

A new report looking into the neonatal care provided for twins suggests improvements are urgently needed.

The Twin pregnancy and neonatal care in England report by the Twins and Multiple Births Association (Tamba) found that admissions of twins to neonatal units could be reduced by a third per year if all neonatal networks had the lowest admission rate (25%).

The report contains information gathered from neonatal networks across the country looking at stillbirth rates, neonatal death rates, NICE compliance and neonatal admissions.

Findings revealed that twins were 2.5 times more likely to result in a stillbirth and more than five times more likely to result in a neonatal death, in comparison to singleton pregnancies.

The report also lists the best and worst performing neonatal networks, with Thames Valley and Wessex ranked the best in terms of the percentage of multiple birth babies requiring neonatal care – just 24.57%. 
The highest percentage of neonatal admissions was in Southern West Midlands, where approximately 88% of multiple birth babies needed the specialist care after they were born.

The report is being submitted to the national review into neonatal services with a call to highlight where and how care should be delivered to multiple birth babies.

Tamba CEO Keith Reed said: ‘This report should act as a red flag for the current national review into neonatal care. They need to consider, in the case of multiple births, if the right level of care is being delivered, by the right team, in the right place and how well their services join up with maternity units.’

Mr Reed added: ‘One pattern which emerges from the report is that neonatal networks which see a larger number of twin births have lower deaths rates, leading us to believe that the more experience they have in caring for multiple births, the better the level of care received. 

‘It is a fundamental question for new Local Maternity Systems across the country to address as they begin to reshape maternity and neonatal services in their area.

‘They also need to consider if there are specific interventions unique to twins, triplets or more that would help to address these wide differences in outcome or if these are a result of the local population. In some places, it looks like great antenatal care was provided but then neonatal outcomes were much worse.

‘Without these actions, these organisations are at risk of failing to meet the government’s target to reduce stillbirths and neonatal deaths, including in multiple pregnancies by 50% by 2030.’ 

Access the full report here