Very preterm infants face high risks of mortality and long-term neuro-developmental impairment. Rates of mortality and morbidity vary by a factor greater than two between European regions. This project's overriding aim is to improve these infants' survival and long-term health and development by ensuring that available medical knowledge is translated into effective perinatal care.
The project will produce empirical data about the uptake of medical interventions in European maternity and neonatal units and new knowledge about catalysts for the adoption of medical knowledge. 19 regions in 11 European countries participate in the EPICE project.
Selection of study interventions: During the first 3 years of the project, a consensus process based on systematic reviews of the scientific literature was carried out to select evidence-based interventions to be included in the project. 17 interventions were included from a broad list of 36 interventions for the project studies. The interventions were selected based on their clinical importance, the solidity of the evidence base, the feasibility of collecting high quality data to measure their use and expected variation between centres. Measures of the use of these interventions will be collected in the cohort studies or the study of health care facilities or both, depending on feasibility.
Regional case studies: We collected data on recommendations from health care governance bodies and professional and scientific societies in participating regions and on the European-level about the interventions included in the project (N=160 documents).
Cohort study and study of neonatal and maternity units During this period, we also developed the protocols and fielded our two principal epidemiological studies: a cohort of very preterm infants (N~10,250) and a study of the maternity and neonatal units care that provide care for them (the unit study)(N=139 maternity units and N=158 neonatal units). Inclusions into the cohort took place between March 2011 and December 2012 in the 19 regions. The cohort provides data on the use of evidence-based interventions for the care of women at risk of very preterm delivery and of very preterm infants in neonatal units from birth to discharge from hospital. Data were also collected on clinical characteristics and health outcomes of very preterm infants.
The maternity and neonatal unit questionnaires collected information on units' characteristics, organisation and policies related to the use of selected interventions and procedures. All babies in the cohort are being followed up at 2 years corrected age; the follow-up started in May 2013. Over 6,000 babies are eligible for follow-up.
The project results will provide scientific knowledge on which to base intervention strategies to improve the use of evidence based medicine for the care of very preterm infants. It will also build a methodological and conceptual base for future scientific work on the effectiveness of intervention strategies. The project enhances cooperation and excellence in Europe by bringing together national research initiatives.