Happy retirement to Professor Ewer’s who leaves a lasting Pulse Ox legacy for babies and families
Today (Thursday 31 March), we’re wishing our colleague and friend, Professor Andrew Ewer, Professor of Neonatal Medicine and Honorary Consultant Neonatologist at our Women’s Hospital, a very happy retirement. He leaves a lasting legacy that is saving the lives of babies not only here but across the globe too.
His passion and expertise has been the driving force behind the introduction of pulse oximetry screening as a test for diagnosing critical congenital heart conditions in newborns. The simple, painless and rapid testing was successfully pioneered at our Women’s Hospital and is now carried out in locations across the world, including the USA, Canada, Spain, Germany, Austria along with many more countries across Europe and Asia.
Each year in the UK, around 1,400 babies are born with congenital heart defects (CHD) and in such cases babies can look apparently healthy after birth but very quickly suffer a serious and life-threatening collapse. Sadly, such conditions account for three per cent of infant mortality.
Pulse oximetry is a non-invasive method for measuring the amount of oxygen in the blood and a low level of oxygen has been found to be one of the indicators for these heart defects. It can also identify other conditions such as Group B streptococcal pneumonia.
Picking up such conditions as early as possible improves the outcomes for children. Routine screening of all newborns usually happens within the first 24 hours of birth and this includes tests of the cardiovascular system, however it’s estimated that around 50 per cent of children with such conditions remain undiagnosed following antenatal ultrasound scans and examinations after birth.
Back in 2006, Prof. Ewer knew that Pulse Ox screening had the potential to pick up such congenital heart defects but, at the time, there was insufficient data to show this.
After securing funding from the National Institute of Health Research Health Technology Assessment Programme, Professor Ewer and his team were able to initiate the Pulse Ox study in six Trusts across the West Midlands; screening 20,000 babies over 12 months. A total of 53 of those had defects detected by Pulse Ox, including 24 who were critical.
Results of the study were published in The Lancet in 2011 showing its effectiveness in detection.
All babies born at our Women’s Hospital, around 8,200 a year, have been routinely screened for more than ten years and many with CHDs have benefitted from early detection allowing speedy treatment thanks to the relatively simple and cost-effective test.
Since then, Prof Ewer’s team has published widely on PulseOx testing, including the unit’s own experience with the development of the technique and a systematic review of evidence from almost half a million screened babies. As word spread of the benefits more and more centres across the UK followed suit and it’s now estimated that over 60 per cent of the country’s maternity centres use Pulse Ox. In addition, millions of more newborns across the globe are tested and Prof. Ewer has regularly travelled the world sharing his experience and knowledge to help others.
Professor Ewer, who has been part of our team for 26 years, although retiring from clinical duties will continue with his research work.
He said: “Over the years there’s been so much work that’s taken place here in Birmingham, involving lots of fantastic people. All committed to pulse oximetry screening to diagnose congenital heart defects, to show this innovative but simple test does work and, most importantly, helps save the lives and reduce the long-term impact felt due to critical congenital heart defects and other serious conditions that may have gone previously undetected.
“Everyone involved at Birmingham Women’s Hospital, which includes all of the families that have helped us, has already made a real difference not just for babies we care for, but for so many others across the globe.
“It’s so gratifying and humbling when I hear from another centre that has introduced Pulse Ox screening and hear that a baby with a congenital heart defect has been picked up and treated. It’s difficult to put a number on how many babies have been saved across the globe. Saving just one would have made things worth it but there will have been many.
“I am very grateful to have worked with an amazing team on the Neonatal Unit. I will miss them all but I know the babies are in very safe hands.”
Dr Fiona Reynolds, Chief Medical Officer at Birmingham Women’s and Children’s NHS Foundation Trust, said: “As the leader and pioneer of pulse oximetry screening Professor Ewer has made an extraordinary contribution to the care of babies across the world. He has shown this simple and inexpensive screening test can find babies with congenital heart disease shortly after birth saving lives by allowing earlier diagnosis.
“Andy has combined his extraordinary research career with a busy clinical job in our tertiary neonatal unit. He is a supportive clinical trainer and research supervisor and has mentored a generation of neonatologists.
“Everyone here would like to wish our colleague and friend a happy retirement.”