The association previously shown for infants <30 completed weeks between urinary NTproBNP and the development of ROP was not seen in more mature infants. Urinary NTproBNP does not appear helpful in rationalising direct ophthalmoscopic screening for ROP in more mature infants, and may suggest a difference in pathophysiology of ROP in this population.

AbstractsBackground Delayed cord clamping is associated with increased neonatal hemoglobin levels, and improved iron status in infants at 4-6 months. There are no previous studies evaluating effects from timing of clamping on development in term infants. Objective Does the time for umbilical cord clamping affect psychomotor development evaluated with Ages and Stages Questionnaire (ASQ) in 4-month infants? Design/methods Randomized controlled trial investigating effect of delayed cord clamping (≥180 sec, DCC) versus early cord clamping (≤10 sec, ECC) in 382 full-term normal deliveries. After 4 months, parents reported their infant's development by the ASQ. Results 365 (96%) questionnaires were returned. The mean total ASQ score did not differ between groups. The DCC group had a higher mean score (SD) in the domain problem solving, 55.3 (7.2) vs. 53.5 (8.2), p=0.03 and a lower score in personal-social; 49.5 (9.3) vs. 51.8 (8.1), p=0.01. There were no difference between the DCC and ECC groups concerning the frequency of infants under cut-off score (table).Abstract 20 Table 1 DCC n(%) ECC n(%) p Communication < 33.3 4 (2.2) 4 (2.2) 1.0

Background Resuscitation guideline for preterm infants has evolved over the last two decades but this still lacks standardisation and clear recommendations. Clinical practice in stabilising preterm infants in the delivery suite may vary from unit to unit. Aims and objectives To find out the current clinical practice in the UK in stabilising the preterm infants in the delivery suite. Study Design and methods Questionnaire based study carried out via internet tool (SurveyMonkey) followed by telephone interview from non-responders. Questionnaire completed by consultants, registrars or senior neonatal sisters (Band 6

AimsInfant mortality rates (IMRs) and causes of death vary according to ethnicity in the UK. IMRs are highest in infants of Pakistani ethnicity. Incidence of congenital anomaly (CA) death is higher in Asian infants. Child Death Overview Panels (CDOPs) perform statutory reviews of all child deaths to identify potentially modifiable factors and prevent future deaths. Reviews are multi-professional, detailed, and systematic. Using CDOP data, we aimed to further describe factors associated with CA infant deaths, in an ethnically diverse, deprived district, with a high IMR.MethodsAnonymised CDOP data for all infant deaths 2008– 2013 was used to compare CA deaths (CDOP Category 7 – Chromosomal, genetic and CAs), with deaths from all other causes. IMRs per 1000 live births were calculated using denominator data obtained from maternity information systems, for all causes, and for CA cause, according to ethnic group (Pakistani, White British and Other) and for all ethnic groups combined. Logistic regression analysis was performed to assess independent associations with CA mortality.ResultsThere were 166 Pakistani, 96 White British and 53 Other deaths. IMRs from all causes (2008–2013) were: Pakistani 9.45 (CI 8.12–10.99), White British 4.09 (CI 3.35–4.99), Other 5.20 (3.98–6.80) and All 6.15 (CI 5.51–6.86). IMRs from CA cause (2008–2013) were: Pakistani 5.46 (CI 4.48–6.66), White British 1.19 (CI 0.83–1.72), Other 1.57 (CI 0.97–2.55) and All 2.73 (CI 2.32–3.22). CA death was independently associated with Pakistani ethnicity (OR 3.40, CI 1.89–6.09), parental consanguinity (OR 4.27, CI 2.32–7.89), and term birth (OR 4.52, CI 2.15– 9.53). CA deaths were not associated with deprivation. CA deaths were less likely to be from limitation of life sustaining treatment (OR 0.38, CI 0.22–0.66), less likely to be ‘modifiable’ (OR 0.18, CI 0.06–0.58), and less likely to be associated with maternal smoking (OR 0.39, CI 0.17–0.89). All p£0.025.ConclusionsThe high IMR in this district’s Pakistani infants is substantially explained by an excess of deaths from CA cause. CA deaths occurred more commonly in consanguineous families. Sensitive use of this information may enable better professional and community understanding of genetic inheritance, improve access to appropriate services, and could contribute to reducing congenital anomaly deaths in future.

AimsChild death overview panels (CDOPs) perform statutory review of all child deaths. Multi-professionals report, discuss and analyse information. Cause of death (COD) is classified by the panel using a standard hierarchical categorisation system. We sought to assess whether CDOP infant data was comparable to that collected for research purposes, by a large, local birth cohort study. We also compared CDOP COD categorisation with another classification system.MethodsCohort study infant deaths were identified and matched to pseudo-anonymised CDOP identification via NHS number. Cohort study interviewer-administered questionnaire data was accessed, and kappa values calculated, to assess agreement of variables from the two data sources. Two investigators (blinded to CDOP categorisation) processed registered COD information using CODAC (Cause of Death and Associated Conditions) Version 2. Discrepancies were discussed and resolved. Proportions of COD classification categories were compared.Results56 cohort study infants had died and been reviewed by CDOP. Kappa values were ‘almost perfect’ (0.81–1.00) for gender, gestation, birth weight, consanguinity, deprivation and smoking in pregnancy, but ‘moderate’ (0.58) for ethnicity. For the 56 deaths, CDOP categorised COD as: 48.2% ‘Chromosomal, Genetic and Congenital Anomalies,’ 30.4% ‘Perinatal/Neonatal events,’ 10.7% ‘Infection,’ 7.1% ‘Sudden, Unexpected, Unexplained Deaths’ and 3.6% ‘Trauma and Other External Factors.’ CODAC classified COD as: 48.2% ‘Congenital Anomaly,’ 17.9% ‘Neonatal,’ 17.9% ‘Infection,’ 7.1% ‘Unknown,’3.6% ‘Intrapartum,’ 3.6% ‘Maternal’ and 1.8% ‘Placental.’ConclusionsHigh levels of agreement suggest CDOP information is valid, despite not being collected for research purposes. Lower levels of agreement in ethnicity are likely to reflect comparison of maternal ethnicity (cohort study gold standard) with infant’s ethnicity. Gestation at recruitment (26–28 weeks) and potential for cohort studies to under-recruit hard to reach populations may mean infants most at risk of death were excluded from the cohort. COD classification was identical for congenital anomaly (known to be high in this district) but other categories were discrepant, or different. CODAC-V2 was chosen for comparison due to its use by MBRRACE (Mothers and Babies: Reducing Risk through audits and confidential enquiries). Designed for perinatal deaths, there is more detail in classification of such, largely accounting for the described COD differences. We suggest CDOP data appears an accurate and valuable source for further examining this district’s infant mortality.