Geography determines survival of babies with birth defects

A global survey of 74 countries found that the survival rate of babies born with birth defects is highly dependent on where the child was born, and Australia has children from other countries. It is sought to play a role in improving surgical care in the world.

Was announced in LancetThe study investigated the mortality risk of nearly 4000 babies born with birth defects in 264 hospitals worldwide. Babies born with birth defects associated with the intestinal tract die in 1 in 5 in middle-income countries and 1 in 20 in high-income countries, compared to 2 in 5 in low-income countries There was a possibility of doing.

2019 John Monash scholar Dr. Brendan Jones, along with Associate Professor Sebastian King and Dr. Dummy Rougehar, is reported to be the largest international study on the outcomes of babies born with major birth defects, a collaboration between Australia and New Zealand. I was the leader of the country.

“Associate Professor Sebastian King, Dr. Dummy Luhar and I coordinate our studies in Australia and New Zealand and are saddened by the incredible disparity between high-income and low-income countries like Australia and New Zealand. But unfortunately it’s not surprising, “Jones said.

“Australia and New Zealand routinely care for children with illnesses such as gastroschisis and expect their babies to not only survive, but also grow and live a fulfilling life. Australia and New Zealand We should be proud to be able to offer this expectation to our children and their parents.

“Following our participation in this study, we encourage Australia and New Zealand to play a leading role in improving surgical care for cross-border children.”

The difference in mortality rates for gastroschisis (a birth defect in which the baby’s intestine protrudes from the umbilicus) is the largest, with 90% of infants dying in low-income countries and 1% dying in high-income countries. In high-income countries, most of these babies can lead a fulfilling life without disabilities.

Principal Investigator Dr. Naomi Wright has been devoted to studying the disparities in these results for the past four years. She states: Sustainable Development Goals to end preventable deaths of newborns and children under the age of 5 by 2030 achieved without urgent action to improve surgical care for infants in low- and middle-income countries you can not. “

Researchers emphasize the need to focus on improving surgical care for newborns in low- and middle-income countries around the world. Over the past 25 years, prevention and treatment of infectious diseases have been very successful in reducing mortality in children under the age of five, but improving surgical care for babies and children, and in fact surgery-related mortality. Little focus was placed on improving proportions. Illness continues to increase.

Birth defects are currently the fifth leading cause of death in children under the age of five in the world, with most deaths occurring during the neonatal period. Birth defects associated with the intestinal tract show particularly high mortality in low- and middle-income countries. This is because many are incompatible with life without emergency surgery after birth.

In high-income countries, most women undergo prenatal ultrasound scans to assess birth defects. If identified, this allows the woman to give birth in a hospital that is receiving surgical care for her child, so that the baby can be helped as soon as she is born. In low- and middle-income countries, babies with these conditions often arrive late at the pediatric surgery center in poor clinical condition. The study shows that infants who come to a pediatric surgery center who are already septic due to an infection are more likely to die.

The study also emphasizes the importance of perioperative care (care received on either side of orthodontics or procedures) at the Pediatric Surgery Center. Infants treated in hospitals that do not have access to ventilation or parenteral nutrition as needed are more likely to die. In addition, without skilled anesthesia support and not using the surgical safety checklist during surgery, there was an increased risk of death.

Researchers have found that improving survival from these conditions in low- and middle-income countries involves three important factors:

  1. Improving prenatal testing and delivery in hospitals with surgical care for children.
  2. Improve surgical care for infants born in district hospitals and transfer them safely and quickly to the Pediatric Surgery Center.
  3. Improved perioperative care for infants at the Pediatric Surgery Center.

The team requires strong teamwork and planning between the midwifery and obstetrics team, the neonatal and pediatric teams, and the pediatric surgery team at the Pediatric Surgery Center, as well as a network of outreach education and referral hospitals. I admit that.

Researchers need to integrate surgical care for newborns and children into national and international child health policies, alongside regional initiatives, which are no longer ignored in global child health. Insist that it should not be.

Image credit: © / au / mocker_bat

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