Pre-term Birth

The British Association of Perinatal Medicine (BAPM) provides a toolkit to support implementation of the key elements of Antenatal Optimisation (AO). The aim of the tool kit is to improve compliance with key evidence-based AO interventions to improve preterm outcomes

Antenatal Optimisation Toolkit

BAPM’s Antenatal Optimisation Toolkit is not intended to be read as mandatory guidance. Instead it is a practical resource from which units who wish to improve compliance rates of antenatal optimisation measures can select the most suitable interventions for their particular context.

Amongst other measures, BAPM recommends that “Singleton infants less than 27 weeks of gestation, multiples less than 28 weeks of gestation and any gestation with an estimated fetal weight of less than 800g should be born in a maternity service on the same site as a neonatal intensive care unit (NICU)”.


Exception Reporting Tool for births <27 weeks in a unit or centre without a Neonatal Intensive Care Unit (NICU)

The Scottish Perinatal Network (SPN) has therefore developed an Exception Reporting tool which can be used in the event this does not happen:

2022-06-01 SPN Exception Reporting Proforma – Birth < 27 Weeks in a Unit or Centre without a NICU

Please complete as much of the Proforma as possible and return it to your local board contact and the SPN on

Data protection measures are in place. For more information on how the NHS handles personal health information please see here.


Why Use the Exception Reporting Proforma?

By recording and returning completed proformas to the SPN, data can be collated. This can help the perinatal community to identify areas of improvement and enable shared learning. The Proforma has been developed based on models which are working well within NHS England and aligns with frameworks from both British Association for Perinatal Medicine (BAPM) and National Neonatal Audit Programme (NNAP). Feedback from these reports will be given to local units on a quarterly basis, and it will also feature as a standing item on both NMN and NNN Core Steering Group agendas.

This reporting tool was launched at the SPN Case Review of Births <27 weeks in a unit without a NICU on 1st June 2022, and the SPN aims to continue hosting this event annually as a shared learning opportunity.