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App developed to determine risk of preterm birth recommended by NHS England

A mobile-phone app and best practice toolkit used to calculate a woman’s individual risk of preterm birth were recently launched due to COVID-19 and are now being recommended by the NHS.

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Earlier this year, a team of researchers led by Professors Andrew Shennan and Rachel Tribe, from the Department of Women & Children’s Health at King’s, supported by Guy’s and St Thomas’ Charity, the National Institute for Health Research and Tommy’s created a user-friendly mobile phone application and best practice toolkit to allow doctors to quickly calculate a woman’s individual risk of preterm birth.

The team planned to launch the QUiPP App Toolkit in September but due to the COVID-19 pandemic a 1st version was rapidly rolled out on 7 April to make sure women who need special treatments get them and decrease unnecessary admissions and transfers by reassuring women when their risk is low. The app has been recommended by NHS England and the team plan to have a 2nd version of the toolkit available by September.

We want to make sure that women and their babies receive the most appropriate care. The QUiPP App Toolkit, which is now recommended by NHS England, provides hospitals across the country the tools to implement the QUiPP app in their unit, enabling them to predict when women are likely to deliver their baby early.– Naomi Carlisle, Senior Research Midwife

When babies are born early, before 37 weeks of pregnancy, they are more likely to die or have physical, developmental and emotional problems. This can result in a huge emotional and financial burden for families and substantial cost for the NHS and care services. Some women are known to be more likely to have their babies early, and some have symptoms of labour too early in pregnancy. If identified, these women can be given extra monitoring and/or treatments that aim to prevent early delivery and ensure the infants have the best chance of surviving without long-term problems.

The QUiPP app uses medical history and fetal fibronectin or cervical length to give an individualised score for the risk of having a spontaneous preterm delivery. In two papers, published in Ultrasound in Obstetrics and Gynecology, the authors show how they developed and tested the complicated algorithms (mathematical calculations) incorporated in the app which calculate the simple % risk. The authors have completed the EQUIPTT trial at St Thomas’ Hospital earlier this year, where they evaluated whether QUiPP improves appropriate targeting of care.

The joy a newborn brings can be cruelly contrasted alongside the fear when a baby is born too soon. Being able to identify mothers at risk of a pre-term birth as early as possible can help clinicians to intervene sooner, improve safety and ultimately save lives.– Nadine Dorries, Patient Safety Minister

The team will continue to collect data which will be used to update the algorithms in the future through the ongoing UK wide PETRA study, and through the Preterm Clinical Network Database which is a global clinical registry of care given to women at risk of preterm birth.

In this story

Naomi  Carlisle

Naomi Carlisle

Senior Research Midwife

Andrew  Shennan

Andrew Shennan

Professor of Obstetrics

Rachel  Tribe

Rachel Tribe

Professor of Maternal and Perinatal Sciences