Professor Andrew Ewer MB ChB, MD, MRCP, FRCPCH

Professor Andrew Ewer

Institute of Metabolism and Systems Research
Professor of Neonatal Medicine

Contact details

Address
Institute of Metabolism and Systems Research
College of Medical and Dental Sciences
Neonatal Unit
Birmingham Women’s Hospital
Edgbaston, Birmingham
B15 2TG

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

Andrew has published research papers in scientific journals 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 Birmingham University 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), 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). 

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

Andrew Ewer qualified with a MB ChB 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 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, Senior Lecturer in 2009, Reader in Neonatal Paediatrics in 2012 and Professor of Neonatal Medicine in 2015.

His research interests include: neonatal gastrointestinal function (particularly gastric function and necrotising enterocolitis), neonatal cardiology and 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 a member of the medical advisory panel of the British Association of Perinatal Medicine and a 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 6 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 is currently a Board member of the NSC pulse oximetry screening pilot programme, which began in 2015.

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

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. I 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 Department of Physiology at Birmingham University 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 2 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 have 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 1300 preterm babies. Final analysis of the data is expected in summer 2015.

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.

Recently, in collaboration with the Clinical Trials Unit at Birmingham University 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.

Clinical trials

Andrew is PI on a number of national clinical trials and is actively involved in supporting local Obstetric and Fetal Medicine trials from a neonatal perspective.

Other activities

Neonatal Paediatrician on the Regional Neonatal Unit at Birmingham Women’s Hospital delivering all aspects of clinical care to babies between birth and discharge from hospital.

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

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

Probert, C, Greenwood, R, Mayor, A, Hughes, D, Aggio, R, Jackson, RE, Simcox, L, Barrow, H, García-Finana, M & Ewer, A 2019, 'Faecal volatile organic compounds in preterm babies at risk of necrotising enterocolitis: the DOVE study', Archives of disease in childhood. Fetal and neonatal edition, pp. F1-F6. https://doi.org/10.1136/archdischild-2019-318221

Hargitai, B, Toldi, G, Marton, T, Ramalingam, V, Ewer, A & Bedford, AR 2019, 'Pathophysiological Mechanism of Extravasation via Umbilical Venous Catheters', Pediatric and Developmental Pathology, vol. 22, no. 4, pp. 340-343. https://doi.org/10.1177/1093526619826714

Fleming, P, Pease, A, Ingram, J, Sidebotham, P, Cohen, MC, Coombs, RC, Ewer, AK, Ward Platt, M, Fox, J, Marshall, D, Lewis, A, Evason-coombe, C & Blair, P 2019, 'Quality of investigations into unexpected deaths of infants and young children in England after implementation of National Child Death Review Procedures in 2008: a retrospective assessment', Archives of Disease in Childhood. https://doi.org/10.1136/ archdischild-2019-317420, https://doi.org/10.1136/archdischild-2019-317420

Comment/debate

Ewer, A 2019, 'Perfusion index cannot be currently recommended as an additional newborn screen for CCHD; more data needed', Archives of Disease in Childhood, vol. 104, no. 5, pp. 411-412. https://doi.org/10.1136/archdischild-2018-316515

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

Ewer, A 2019, 'Pulse oximetry screening for critical congenital heart defects: a life-saving test for all newborn babies', International Journal of Neonatal Screening, vol. 5, no. 1, 14. https://doi.org/10.3390/ijns5010014

Letter

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