New research could save the lives of premature babies

Zach Power with his mum

The results of the PlaNet-2/Matisse study could lead to safer and more effective medical treatment for premature babies, and could save lives.

More than 70 babies from our neonatal unit took part in a ground-breaking trial which looked at giving platelet transfusions, the cells that help the blood to clot, to babies born before 34 weeks.

Evelina London was the highest recruiter of premature babies to the study, which included over 40 neonatal units.

Results, published in the New England Journal of Medicine, found that lowering the threshold and giving fewer platelet transfusions will prevent death or major bleeding in 7 out of 100 premature newborn babies with low platelet counts.

Until now doctors did not know the correct platelet count at which they should start giving transfusions to premature babies when they were not bleeding. Platelets are often given to babies with low platelet counts and no signs of bleeding to try to prevent bleeding.

Unexpectedly researchers found that giving platelet transfusions to babies at the higher platelet count was associated with a worse outcome, compared with only transfusing babies with a lower count.

Dr Timothy Watts, head of the neonatal unit at Evelina London and local principal investigator for the study, said: “This landmark study provides clinicians with clearer guidance of when to give platelet transfusions to premature babies. This will improve care for premature babies and ultimately reduce their risk of serious complications and even death.

“We don’t really know why giving platelet transfusions to premature babies with a higher platelet count has an adverse outcome. It could be because the blood products overwhelm their circulation, but we will need further research to fully understand the reasons why.

“We are really grateful to all the families who took part in the study. We couldn’t have done the research without their support and generosity. Their involvement will mean that there will be many babies whose lives will be saved because of them.”

Shona Power, 41, from Clapham in South London, enrolled her son Zach in the PlaNet-2 study after he was born prematurely at 28 weeks in May 2016.

Shona said: “I decided to enrol Zach 24 hours after he was born. It was a massive shock having a premature baby but it felt really empowering knowing that we were doing something worthwhile and that Zach’s involvement could save the lives of premature babies in the future.

“I was very aware that the main reason why Zach survived being born so early was due to cutting edge research, so this was my way of giving back. Zach is now participating in five other studies.”

Shona who is a freelance lawyer added: “Zach spent the first five months of his life in the Evelina London neonatal unit and the team who looked after him were amazing. I really couldn’t thank them enough for their care and support. I’ve formed very strong bonds with all the nurses and doctors who were involved in his care.

“Zach is now an active cheeky two-year-old boy who loves animals and singing. You would never know that he had such a difficult start in life.”

Dr Watts said: “I am proud of our achievement as the highest recruiting centre for PlaNet-2, and the key role we played in the development of the study. This shows how engaged our clinical team is in driving improvements in medical care through research.”

During the study babies were allocated by chance into two groups if there platelet count fell below 50. One group received a platelet transfusion as their platelet count dropped below 50, while the other group received a platelet transfusion but only whenever their platelet count dropped below 25. More than 600 babies were involved in the study, which was conducted over a six year period.

The PlaNeT-2 study was funded by NHS Blood and Transplant (NHSBT), Sanquin Research, Amsterdam in the Netherlands and Addenbrooke’s Charitable Trust Neonatal Breath of Life Fund. It was supported by the NHSBT Clinical Trials Unit and was adopted on the NIHR portfolio of clinical trials.