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Improved referral and survival of newborns after scaling up of intensive care in Suriname

Zonneveld, R., Holband, N., Bertolini, A., Bardi, F., Lissone, N. P. A., Dijk, P. H., Plotz, F. B. & Juliana, A., 14-Nov-2017, In : BMC Pediatrics. 17, 8 p., 189.

Research output: Contribution to journalArticleAcademicpeer-review

Background: Scaling up neonatal care facilities in developing countries can improve survival of newborns. Recently, the only tertiary neonatal care facility in Suriname transitioned to a modern environment in which interventions to improve intensive care were performed. This study evaluates impact of this transition on referral pattern and outcomes of newborns.

Methods: A retrospective chart study amongst newborns admitted to the facility was performed and outcomes of newborns between two 9-month periods before and after the transition in March 2015 were compared.

Results: After the transition more intensive care was delivered (RR 1.23; 95% CI 1.07–1.42) and more outborn newborns were treated (RR 2.02; 95% CI 1.39–2.95) with similar birth weight in both periods (P=0.16). Mortality of inborn and outborn newborns was reduced (RR 0.62; 95% CI 0.41–0.94), along with mortality of sepsis (RR 0.37; 95% CI 0.17–0.81) and asphyxia (RR 0.21; 95% CI 0.51–0.87). Mortality of newborns with a birth weight <1000 grams (34. 8%; RR 0.90; 95% CI 0.43–1.90) and incidence of sepsis (38.8%, 95% CI 33.3–44.6) and necrotizing enterocolitis (NEC) (12.5%, 95% CI 6.2–23.6) remained high after the transition.

Conclusions: After scaling up intensive care at our neonatal care facility more outborn newborns were admitted and survival improved for both in-and outborn newborns. Challenges ahead are sustainability, further improvement of tertiary function, and prevention of NEC and sepsis.

Original languageEnglish
Article number189
Number of pages8
JournalBMC Pediatrics
Volume17
Publication statusPublished - 14-Nov-2017

    Keywords

  • NICU, Low-resource setting, Developing country, Neonatal mortality, Suriname, BIRTH-WEIGHT INFANTS, NEONATAL-MORTALITY, PERINATAL-MORTALITY, IMPACT, INDIA, COUNTRIES, OUTCOMES, CENTERS, VOLUME, LEVEL

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