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  • Journal article
    Watson SI, Arulampalam W, Petrou S, Marlow N, Morgan AS, Draper ES, Santhakumaran S, Modi Net al., 2014,

    The effects of designation and volume of neonatal care on mortality and morbidity outcomes of very preterm infants in England: retrospective population-based cohort study

    , BMJ OPEN, Vol: 4, ISSN: 2044-6055
  • Journal article
    Modi N, 2014,

    Probiotics and Necrotising Enterocolitis: The Devil (as Always) Is in the Detail

    , NEONATOLOGY, Vol: 105, Pages: 71-73, ISSN: 1661-7800
  • Journal article
    Cole TJ, Statnikov Y, Santhakumaran S, Pan H, Modi Net al., 2013,

    Birth weight and longitudinal growth in infants born below 32 weeks’ gestation: a UK population study

    , Archives of Disease in Childhood-Fetal and Neonatal Edition, Vol: 99, Pages: F34-F40, ISSN: 1468-2052

    OBJECTIVE: To describe birth weight and postnatal weight gain in a contemporaneous population of babies born <32 weeks' gestation, using routinely captured electronic clinical data. DESIGN: Anonymised longitudinal weight data from 2006 to 2011. SETTING: National Health Service neonatal units in England. METHODS: Birth weight centiles were constructed using the LMS method, and longitudinal weight gain was summarised as mean growth curves for each week of gestation until discharge, using SITAR (Superimposition by Translation and Rotation) growth curve analysis. RESULTS: Data on 103 194 weights of 5009 babies born from 22-31 weeks' gestation were received from 40 neonatal units. At birth, girls weighed 6.6% (SE 0.4%) less than boys (p<0.0001). For babies born at 31 weeks' gestation, weight fell after birth by an average of 258 g, with the nadir on the 8th postnatal day. The rate of weight gain then increased to a maximum of 28.4 g/d or 16.0 g/kg/d after 3 weeks. Conversely for babies of 22 to 28 weeks' gestation, there was on average no weight loss after birth. At all gestations, babies tended to cross weight centiles downwards for at least 2 weeks. CONCLUSIONS: In very preterm infants, mean weight crosses centiles downwards by at least two centile channel widths. Postnatal weight loss is generally absent in those born before 29 weeks, but marked in those born later. Assigning an infant's target centile at birth is potentially harmful as it requires rapid weight gain and should only be done once weight gain has stabilised. The use of electronic data reflects contemporary medical management.
  • Journal article
    Murray J, Saxena S, Modi N, Majeed A, Aylin P, Bottle Aet al., 2013,

    Quality of routine hospital birth records and the feasibility of their use for creating birth cohorts

    , JOURNAL OF PUBLIC HEALTH, Vol: 35, Pages: 298-307, ISSN: 1741-3842
  • Journal article
    Parkinson JRC, Hyde MJ, Gale C, Santhakumaran S, Modi Net al., 2013,

    Preterm Birth and the Metabolic Syndrome in Adult Life: A Systematic Review and Meta-analysis

    , PEDIATRICS, Vol: 131, Pages: E1240-E1263, ISSN: 0031-4005
  • Journal article
    Gale C, Santhakumaran S, Nagarajan S, Statnikov Y, Modi Net al., 2012,

    Impact of managed clinical networks on NHS specialist neonatal services in England: population based study

    , British Medical Journal, Vol: 344, ISSN: 1468-5833

    Objective To assess the impact of reorganisation of neonatal specialist care services in England after a UK Department of Health report in 2003.Design A population-wide observational comparison of outcomes over two epochs, before and after the establishment of managed clinical neonatal networks.Setting Epoch one: 294 maternity and neonatal units in England, Wales, and Northern Ireland, 1 September 1998 to 31 August 2000, as reported by the Confidential Enquiry into Stillbirths and Sudden Deaths in Infancy Project 27/28. Epoch two: 146 neonatal units in England contributing data to the National Neonatal Research Database at the Neonatal Data Analysis Unit, 1 January 2009 to 31 December 2010.Participants Babies born at a gestational age of 27+0-28+6 (weeks+days): 3522 live births in epoch one; 2919 babies admitted to a neonatal unit within 28 days of birth in epoch two.Intervention The national reorganisation of neonatal services into managed clinical networks.Main outcome measures The proportion of babies born at hospitals providing the highest volume of neonatal specialist care (≥2000 neonatal intensive care days annually), having an acute transfer (within the first 24 hours after birth) and/or a late transfer (between 24 hours and 28 days after birth) to another hospital, assessed by change in distribution of transfer category (“none,” “acute,” “late”), and babies from multiple births separated by transfer. For acute transfers in epoch two, the level of specialist neonatal care provided at the destination hospital (British Association of Perinatal Medicine criteria).Results After reorganisation, there were increases in the proportions of babies born at 27-28 weeks’ gestation in hospitals providing the highest volume of neonatal specialist care (18% (631/3495) v 49% (1325/2724); odds ratio 4.30, 95% confidence interval 3.83 to 4.82; P<0.001) and in acute and late postnatal transfers (7% (235) v 12% (360) and 18% (579)

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