Professor Andrew Ewer MB ChB, MD, MRCP, FRCPCH

Professor Andrew Ewer

Institute of Metabolism and Systems Research
Professor of Neonatal Medicine
Impact Lead, College of Medical and Dental Sciences

Contact details

Telephone
+44 (0) 121 623 6631
Fax
+44 (0) 121 627 2749
Email
a.k.ewer@bham.ac.uk
Twitter
@a_ewer
View my research portal
Address
Institute of Metabolism and Systems Research
College of Medical and Dental Sciences
Neonatal Unit
Birmingham Women’s Hospital
Edgbaston, Birmingham
B15 2TG
Pulse oximetry screening - saving babies' lives - Professor Andrew Ewer

Andrew Ewer is Professor of Neonatal Medicine based at Birmingham Women’s Hospital

Andrew has published research papers in scientific journals including Lancet, NEJM and Cochrane library, as well as reviews and an undergraduate problem-based learning book in the field of paediatrics and neonatology. He has received grants from NIHR Health Technology Assessment, NIHR Efficacy and Mechanism Evaluation and Action Medical Research

He led the PulseOx trial investigating pulse oximetry as a screening test for congenital heart defects in newborn babies. As a result of this work, he was nominated for the Charles Beale Founder's Award for Excellence in Policy Development in May 2012. The study was included in the 2012 NIHR Evaluation, Trials and Studies annual report and was described as a ‘Research Highlight’ in the 2012 NIHR annual report and as ‘a new milestone in the history of congenital heart disease’ in a Lancet editorial.

In 2015, the PulseOx study was selected as the entry for the University of Birmingham in ‘Health of the Nation’ published by the Medical Schools Council following REF 2014. Since then, he has worked on further evidence synthesis including a Cochrane review in 2017 (involving over 450,000 babies) and development of the screening algorithm and international advocacy of pulse oximetry screening. As a direct result of his work many developed countries now recommend routine screening (including USA, Canada, New Zealand, Switzerland, Spain, Germany, Sweden, Norway, Denmark, Finland, Iceland, Poland, Sri Lanka, Saudi Arabia, South and Central American countries).

He has previously worked with the UK National Screening Committee, undertaking the UK PulseOx pilot study in 2015 and contributed to two national consultations on pulse oximetry screening.

His work was again submitted as a impact case study for the 2021 REF. 

Qualifications

  • MD – University of Birmingham 1998
  • Fellowship of Royal College of Paediatrics and Child Health 1996
  • Membership to the Royal College of Physicians 1989
  • MBChB – University of Birmingham 1985

Biography

Screening heart disease in newborn babies

Andrew Ewer qualified with a MBChB in Medicine and Surgery from the University of Birmingham in 1985. He trained in paediatrics in Birmingham and Sheffield and gained MRCP in 1989. He won a Sheldon Research Training Fellowship in 1991 and investigated gastric emptying and gastro-oesophageal reflux in preterm infants. Following this, in 1994 he won a fellowship to Monash Medical Centre in Melbourne, Australia and continued his clinical training and research there.

He returned to the University of Birmingham as Lecturer in Neonatal Paediatrics and was awarded FRCPCH in 1997 and an MD degree from the University of Birmingham in 1998. He was appointed as Senior Research Fellow and Honorary Consultant Neonatologist at Birmingham Women’s Hospital. He was appointed Senior Lecturer at the University of Birmingham in 2009, Reader in Neonatal Paediatrics in 2012 and Professor of Neonatal Medicine in 2015.

His research interests include: newborn screening, neonatal gastrointestinal function (particularly gastric function and necrotising enterocolitis), neonatal cardiology and perinatal clinical trials.

He is an invited referee for 22 peer-reviewed journals and is an associate editor of the journal Archives of Disease in Childhood Fetal and Neonatal Edition. He is President elect of the UK Neonatal Society and a past member of two national clinical studies groups; the Intrapartum Care CSG and the MCRN/AMR CSG. He is a member of the Trial Steering Committee for six national clinical trials.

In 2011 he was invited as an advisor to the United States Health Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children workgroup on Screening for Critical Congenital Cyanotic Heart Disease. Screening was subsequently endorsed by the US Health Secretary and is being implemented as national policy. Since 2012, he has been an advisor to the Newborn and Infant Physical Examination group on the UK National Screening Committee (NSC) and was a board member of the NSC pulse oximetry screening pilot programme, which began in 2015.

Since 2015, he has been College Impact Lead for the College of Medical and Dental Sciences, leading the College's REF Impact submission.

Teaching

Teaching Programmes

  • MBChB
  • Year 2 – Module on temperature regulation in newborns
  • Year 5 – Coordinator of neonatology teaching
  • Examiner for final year paediatrics

Postgraduate supervision

Andrew has supervised PhD and MD postgraduate students in laboratory and clinical research.

Research

Research themes

Newborn screening, neonatal gastrointestinal function (particularly gastric function and necrotising enterocolitis), neonatal cardiology and clinical trials.

Research activity

Gastrointestinal function in preterm infants

i) Gastric emptying

Using a novel ultrasonic technique, Andrew investigated the effect of feed-type on gastric emptying rates. While in Melbourne, he investigated the effect of breast milk fortifier on gastric emptying.

ii) Gastro-oesophageal reflux

He also investigated the relationship between delayed gastric emptying and gastro-oesophageal reflux using techniques developed within the department. He also supervised a project investigating methods of detecting reflux and the effect of body position on the severity of reflux.

Necrotising enterocolitis

Andrew has collaborated with Professor Janice Marshall in the Institute of Cardiovascular Sciences, University of Birmingham, over a number of years and developed a unique animal model for necrotising enterocolitis and devised a research protocol and grant applications in order to investigate the role of inflammatory mediators (particularly platelet-activating factor) in the aetiology of the disease. He co-supervised two PhD students who were involved in both in-vivo and in-vitro work using this model.

In a recent collaboration with a team from Bristol University, he has also been investigating faecal volatile organic compounds as a biomarker for NEC. This work successfully secured funding through an Action Medical Research project grant and Professor Ewer led the DOVE study, a multicentre trial which successfully recruited over 1,300 preterm babies.

Neonatal cardiology

In collaboration with the Cardiology Unit at Birmingham Children’s Hospital, Andrew has supervised four research fellows in neonatal cardiology. They have investigated postnatal outcomes for babies diagnosed with congenital heart disease and developed the technique of tissue Doppler assessment of neonatal myocardial function.

In collaboration with the University of Birmingham Clinical Trials Unit he secured HTA funding and undertook a multicentre trial examining the use of pulse oximetry as a screening procedure to detect congenital heart disease in newborn babies (PulseOx study).

Clinical trials

Andrew is a co-applicant on several NIHR-funded multicentre clinical trials including HOLDS, iHOLDS, CSTICH and CSTICH 2.

Other activities

Andrew is an Honorary Consultant Neonatologist on the Regional Neonatal Unit at Birmingham Women’s Hospital delivering all aspects of clinical care to babies between birth and discharge from hospital.

Andrew is President Elect of the UK Neonatal Society.

Publications

Recent publications

Article

Wood, H, Acharjee, A, Pearce, H, Quraishi, MN, Powell, R, Rossiter, A, Beggs, A, Ewer, A, Moss, P & Toldi, G 2021, 'Breastfeeding promotes early neonatal regulatory T-cell expansion and immune tolerance of non-inherited maternal antigens', Allergy. https://doi.org/10.1111/all.14736

Israfil-Bayli, F, Morton, VH, Hewitt, CA, Ewer, AK, Gray, J, Norman, J, Lees, C, Simpson, NAB, Shennan, A, Tryposkiadis, K, Hughes, M, Daniels, J, Brocklehurst, P, Morris, K, Middleton, L & Toozs-Hobson, P 2021, 'C-STICH: Cerclage Suture Type for an Insufficient Cervix and its effect on Health outcomes—a multicentre randomised controlled trial', Trials, vol. 22, no. 1, 664. https://doi.org/10.1186/s13063-021-05629-3

Kwache, I, Meher, S, Balogun, M, Ewer, A & Toldi, G 2021, 'Fetal ultrasound diagnosis allows effective early postnatal treatment of hematometrocolpos', Clinical Case Reports, vol. 9, no. 5, e04088. https://doi.org/10.1002/ccr3.4088

Embleton, ND & Ewer, A 2021, 'Lactoferrin impact on gut microbiota in preterm infants with late-onset sepsis or necrotising enterocolitis: the MAGPIE mechanisms of action study', Efficacy and Mechanism Evaluation, vol. 8, no. 14. https://doi.org/10.3310/eme08140

Henderson, A, Aguirre, D, Singh, A & Ewer, A 2021, 'Temporal trends in routine predischarge pulse oximetry screening: 6 years’ experience in a UK regional neonatal unit', Archives of disease in childhood. Fetal and neonatal edition. https://doi.org/10.1136/archdischild-2021-322303

Coomarasamy, A, Harb, HM, Devall, AJ, Cheed, V, Roberts, TE, Goranitis, I, Ogwulu, CB, Williams, HM, Gallos, ID, Eapen, A, Daniels, JP, Ahmed, A, Bender-Atik, R, Bhatia, K, Bottomley, C, Brewin, J, Choudhary, M, Crosfill, F, Deb, S, Duncan, WC, Ewer, A, Hinshaw, K, Holland, T, Izzat, F, Johns, J, Lumsden, MA, Manda, P, Norman, JE, Nunes, N, Overton, CE, Kriedt, K, Quenby, S, Rao, S, Ross, J, Shahid, A, Underwood, M, Vaithilingham, N, Watkins, L, Wykes, C, Horne, AW, Jurkovic, D & Middleton, LJ 2020, 'Progesterone to prevent miscarriage in women with early pregnancy bleeding: The PRISM RCT', Health Technology Assessment, vol. 24, no. 33, pp. 1-70. https://doi.org/10.3310/hta24330

Martin, GR, Ewer, A, Gaviglio, A, Hom, LA, Saarinen, A, Sontag, M, Burns, KM, Kemper, AR & Oster, ME 2020, 'Updated strategies for pulse oximetry screening for critical congenital heart disease', Pediatrics, vol. 146, no. 1, e20191650. https://doi.org/10.1542/peds.2019-1650

PREVAIL trial team 2019, 'Antimicrobial-impregnated central venous catheters for prevention of neonatal bloodstream infection (PREVAIL): an open-label, parallel-group, pragmatic, randomised controlled trial', The Lancet Child and Adolescent Health, vol. 3, no. 6, pp. 381-390. https://doi.org/10.1016/S2352-4642(19)30114-2

Stockley, EL, Singh, A, Desai, T & Ewer, A 2019, 'Can fetal echocardiograms reliably predict the need for urgent balloon atrial septostomy in transposition of the great arteries?', Archives of Disease in Childhood. https://doi.org/10.1136/archdischild-2019-317867

Ward, J, Motwani, J, Baker, N, Nash, M, Ewer, AK & Toldi, G 2019, 'Congenital methemoglobinemia identified by pulse oximetry screening', Pediatrics, vol. 143, no. 3, e20182814. https://doi.org/10.1542/peds.2018-2814

Editorial

Ewer, A 2021, 'Perfusion index as a screening test for neonatal aortic coarctation: should we be using it routinely?', Acta Paediatrica. https://doi.org/10.1111/apa.15768

Letter

Macaskill, L, Slee, S, van Hasselt, TJ, Naseem, M, Ewer, A & Surana, P 2021, 'Impact of the new NICE guidance 2021 on management of early onset neonatal sepsis', Archives of disease in childhood. Fetal and neonatal edition. https://doi.org/10.1136/archdischild-2021-322822

van Hasselt, TJ, McDermott, H, Surana, P, Eltahir, R, Macaskill, L, Jain, R, McMullan, N, Slee, S, Jagga, M, Naseem, M, Alake, O, Cherry, C, Miguras, B & Ewer, A 2020, 'Impact of neonatal sepsis calculator in West Midlands (UK)', Archives of disease in childhood. Fetal and neonatal edition. https://doi.org/10.1136/archdischild-2020-320862

Brown, S, Liyanage, S, Mikrou, P, Singh, A & Ewer, A 2020, 'Newborn pulse oximetry screening in the UK: 2020 survey', The Lancet, vol. 396, no. 10255, P881. https://doi.org/10.1016/S0140-6736(20)31959-0

Review article

Mone, F, Quinlan-Jones, E, Ewer, A & Kilby, M 2019, 'Exome sequencing in the assessment of congenital malformations in the fetus and neonate', Archives of disease in childhood. Fetal and neonatal edition, vol. 104, pp. F452-F456. https://doi.org/10.1136/archdischild-2018-316352

View all publications in research portal

Expertise

Maternal health, newborn screening.