NMH

NMH | 2024 43 Neonatology outcomes with the Vermont Oxford Network (VON) and the National Perinatal Epidemiology Centre (NPEC). Our NICU is one of 4 centres in the country that provides therapeutic hypothermia to infants with Hypoxic Ischaemic Encephalopathy (HIE). In 2024, a total of 19 infants (7 inborn and 12 outborn) were reported with HIE of which 19 (7 inborn and 12 outborn) received therapeutic hypothermia. A further 2 infants (2 inborn and 0 outborn) were diagnosed with Neonatal Encephalopathy but did not meet the criteria for HIE. All 2 of these underwent therapeutic hypothermia. Details on these cases are included in this report (see Neonatal Encephalopathy section). In late 2023, we launched the Early Detection and Intervention for Cerebral Palsy in Ireland (EDI-CPI) project. This initiative aims to reduce the age at diagnosis of cerebral palsy (CP) to < 12 months of age. It is supported by the Cerebral Palsy Foundation in the United States and has been rolled out nationally across all 4 tertiary maternity hospitals. The project involves identifying newborn babies who are at higher risk of developing CP prior to NICU discharge and following these babies in a structured way with regular neurological examinations in the outpatient setting (baby clinic and neonatal physiotherapy outpatients). Where neurodevelopmental concerns arise, there is a formal pathway for referral to a more specialised neurodevelopmental clinic in NMH and MRI brain/genetic investigations as appropriate. In 2024, we continued to improve on recruitment and retention to the study. The CP early detection team in NMH have undergone significant training and have invested huge time and energy into this project. I would like to take this opportunity to thank everyone involved. Another significant development in our neonatal service over 2024 has been the neonatal MRI service in NMH. We are now able to offer neonatal inpatients a MRI scan within 2-3 days. For NMH infant outpatients, we have high success rates with 'Feed and Wrap' MRI scans up to the age of 16 weeks corrected gestational age. This is no small feat and in the main part, this success rate is due to the skill and dedication of our neonatal MRI nurses with the support of the NMH radiology team. We have further expanded this service to include babies from the Rotunda Hospital who require MRI scans and we are in discussions with the Coombe Hospital also. 2024 saw the role out of the first respiratory syncytial virus (RSV) immunisation programme (Nirsevimab) for all newborn infants born in NMH from 1 st September 2024. This immunisation is > 80% effective and protects babies for the first 150 days of life and is particularly effective in reducing the incidence of severe RSV infection. We had very high uptake rates in NMH (>80%), congratulations to all the midwifery, nursing, medical and education and training staff who helped to make this programme such a success. Our outpatient clinic continued to be very busy, with numbers attending increasing year on year. In all, 3,128 babies were seen in clinic of which 1,821 were first-time visits and 1,307 were follow-up visits. Apart from overseeing the patients who attend, the outpatient nursing and administrative staff triage numerous queries, provide a huge amount of advice over the telephone to families, GPs and community services and follow up on a myriad of investigations and referrals. While a large part of this work often goes unnoticed, the clinic could not provide such a good service to our families without their dedication. We have also recently developed a specialised multi-disciplinary clinic for follow-up of the ex-NICU high risk babies (ACORN clinic, see below). The neonatal Clinical Psychologist, Marie Slevin, continues her important work in seeing all our NICU graduates at 2 years corrected age for a detailed neurodevelopmental assessment. Such data are invaluable by providing us with important feedback as to how our babies do in the long-term. Additionally, these assessments can provide families with very useful information that can be used to lobby for additional resources for their infant, if required. Staying with the neonatal follow-up theme, we held our World Prematurity Day Coffee afternoon for ex-NMH NICU graduates on Sunday 17 th November 2024. We invited 173 families in advance and almost 60 families attended on the day. This event was a resounding success with a huge attendance. The neonatal team pulled out all the stops for our ex-NICU families; there was a clown doctor, a photo-booth, a soft play area, a 'mini-hospital play area', finger painting, arts and crafts area and lots of purple cupcakes. It provided a lovely opportunity for families to return to NMH with their infants and toddlers for a happy, social occasion where they got to meet up with other families and with the nurses and doctors who cared for their babies while they were in the NICU. Research plays a central and important role in the Neonatal Unit. In 2024, five Neonatology Specialist Registrars performed clinical research in the Department for higher degrees at UCD. Dr Caitriona Ní Chathasaigh studied airway management of newborns, supervised by Dr. Anna Curley and Dr. Eoin Ó Curraín; and Dr. Lucy Geraghty studied the use of videolaryngoscopy for intubation of newborns, supervised by Prof Colm O'Donnell. Dr Elizabeth Murphy, Dr Laura Ryan, Dr Robert Joyce all commenced their higher degrees in neonatal research in 2024. The Department also participated in several multi-centre trials. Our NCHDs and nursing staff are encouraged to participate in local projects and audits, and to present their work at local and international meetings. We are

• Cover