This MOSAIC project, 'Models of OrganiSing Access to Intensive Care for very preterm births,' financed by the DG-RESEARCH, European Commission, conducted a cohort study of births between 22 and 31 weeks' gestation in 10 European regions (7222 very preterm babies) and a descriptive survey of the organization of obstetrics and neonatology departments in these regions (428 maternity units and 290 neonatal intensive care units (NICUs).
Our principal aim was to assess the regionalisation of care for very preterm infants in Europe. We showed that there were many approaches to the organisation of obstetric and neonatal care for very preterm infants and that the differences in organisation impacted on the way care was provided and on the health outcomes of this population. Our analyses brought to light large differences in the rates of very preterm mortality and neurological and respiratory morbidity between the 10 participating regions as well as variability in the use of medical interventions for the care of preterm infants, such as caesarean section, antenatal corticosteroids and mechanical ventilation.
The results of the MOSAIC study led us to the research questions which underlie the EPICE project. We wished to get more detail about the care received by very preterm infants in obstetric and neonatal units and to assess how evidence-based interventions were used. We also realized the importance of combining qualitative with quantitative methods in order to understand more fully the context in which care decisions are made.