Background: Although late and moderate prematurity (32-36 weeks´ gestation) represents 75% of preterm births, research in these infants is sparse. However, data from small or retrospective studies consistently suggest they are at greater risk of adverse outcomes than previously recognised.

Hypoxic-ischaemic encephalopathy (HIE) incidence is an important perinatal care quality measure as it is a near-miss marker of intrapartum-related stillbirth and neonatal death. Currently there are worldwide clinical and epidemiological HIE case definition inconsistencies. This has implications for clinical neonatal care and perinatal care quality research and audit. A literature review of clinical findings and their validity in HIE was conducted in response to a need identified by the National Patient Safety Association, the National Perinatal Epidemiology Unit and a systematic review of international population-based data. The literature review found heterogeneous descriptions of clinical findings and clinical definitions in HIE, with no study to date either comparing clinical findings in HIE with those in neonatal encephalopathy due to other causes, or validating a clinical definition using imaging techniques. A subsequent literature review found that MRI and magnetic resonance spectroscopy have been found to have good specificity and sensitivity for diagnosis of HIE. This review, together with an ongoing national clinician consensus-building exercise led by the NPEU have led to the designing of a retrospective study to serially revise and validate a simple definition of HIE for future clinical and research use in order to improve the quality of epidemiological, health care quality and therapeutic research into HIE.

Background: Pharmacokinetic (PK) studies are difficult to conduct in neonates, due to the repeated need for blood sampling. A PK study of caffeine was undertaken using dried blood spots (DBS) taken opportunistically during other blood tests. We designed a qualitative study to investigate the acceptability of this novel technique to parents and nurses on the neonatal unit.

Background:Little is known about how nursing staff view their participation in clinical research, especially within neonatal care. It has been suggested that nurses are generally supportive of research, although participation may be influenced by time pressures, care of their patient, and limited experience of research. We designed a qualitative study to explore these influences.