Obstetrics without an on site paediatrician.

Area of Science:

• Perinatal Medicine
• Neonatal Care
• Public Health Statistics

Background:

• Review of Wexford perinatal statistics from 1980-1989.
• Focus on neonatal deaths and transfer rates for healthy infants.
• Observed increase in pediatrician visits in the final two years.

Purpose of the Study:

• To analyze trends in perinatal care in Wexford over a ten-year period.
• To investigate the association between pediatrician visits and neonatal transfer rates.
• To evaluate the impact on neonatal mortality and argue for improved on-site pediatric services.

Main Methods:

• Retrospective analysis of ten years of perinatal data (1980-1989).
• Examination of neonatal mortality rates.
• Assessment of infant transfer rates to a regional unit.

Main Results:

• Neonatal mortality rates showed no improvement during the study period.
• Increased pediatrician visits correlated with a higher rate of neonatal transfers to a regional unit 40 miles away.
• The impact on overall infant morbidity was not assessed.

Conclusions:

• The current model of care may lead to increased transfers without demonstrable improvements in mortality.
• There is a need for on-site pediatric expertise, including at least two consultants.
• Continuous on-site pediatric consultant presence is advocated to improve neonatal care outcomes.