Cooling therapy for vulnerable newborns achieves 88 per cent survival rate

Almost 90 per cent of newborns who received a pioneering therapy aimed at preventing brain damage due to oxygen starvation during birth survived, according to a report.

A total of 140 infants underwent brain and body-cooling treatment in four Irish hospitals in 2016 and 2017 after experiencing reduced oxygen or blood supply at birth. Seventeen of them died, giving a survival rate of 88 per cent, according to the annual report of the programme.

The treatment, known as therapeutic hypothermia, is regarded as the greatest single advance in neonatology over the past 25 years as research has shown it reduces the death rate and the rate of severe disability and cerebral palsy among affected children.

However, the therapy is available in only four Irish hospitals - the National Maternity Hospital, Rotunda and Coombe in Dublin, and Cork University Maternity Hospital - and a review shows 40 per cent of newborns requiring it had to be transferred from a local maternity unit.

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One in 900 infants born in Ireland during the period needed the therapy, the report estimates.

Mothers in their first pregnancy accounted for 60 per cent of cases, suggesting these mothers may be at increased risk of needing the therapy.

Almost half of the newborns - 47 per cent - were delivered by caesarean section. Roughly half of these mothers had a section before onset of labour and half were sectioned after labour had begun.

The review, which was sparked by a gap in the knowledge available to doctors and hospital managers about the treatment, says ongoing national review of cases is required. Regular training updates and the creation of an electronic register of all infants treated with therapeutic hypothermia is also recommended.

Under the treatment, babies are cooled within six hours of birth to a targeted core body temperature of between 33-34 degrees for a duration of 72 hours. They are then rewarmed to normal body temperature over a six to 12 hour period.